Implementing the Affordable Care Act

The Patient Protection and Affordable Care Act (ACA) represents one of the most sweeping reforms of the U.S. health care system ever enacted.

RAND’s analysis of the ACA has examined the impact of the law’s key provisions, how the law has evolved during the course of implementation, and changes to the number of uninsured during this initial period.

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  • Research Brief

    How Would Alternative Subsidy Structures Affect Stability in the ACA Individual Market?

    Apr 6, 2015

    Subsidies in the ACA's health insurance exchanges help stabilize the insurance market by encouraging younger, healthier people to stay enrolled in the face of premium hikes. Critics of the current subsidies have proposed alternatives. What effects would these have?

  • Research Brief

    How Does Enrollment of Young Invincibles Affect Premiums in the ACA Individual Market?

    Feb 5, 2015

    Using the COMPARE microsimulation model, researchers estimated the effects of reduced enrollment of young adults (invincibles) in the individual health insurance market. Results indicate that reduced enrollment of invincibles is associated with only modest premium increases.

  • Research Brief

    How Do ACA Tax Subsidies Affect Premiums and Enrollment?

    Jan 16, 2015

    An estimated 85 percent of people who enrolled in the Affordable Care Act's exchanges in 2014 received tax credits. Now, the Supreme Court will determine the legality of these subsidies in 34 states. Eliminating them will result in a substantial disruption to the market.

  • Research Brief

    Improving Outcomes for Substance Use Patients: Quality Measures May Be Necessary

    Jan 16, 2015

    The Affordable Care Act significantly increases coverage for substance use treatment, but it does not define quality measures—which are essential to monitoring and improving treatment. Thus, increased coverage may not translate into better outcomes unless existing measures are refined and new measures are developed and tested.