Health Care Reform


The debate within the U.S. government about reforming the health care system centers on ways to control rising costs and assure high-quality, affordable care. RAND Health and its health care reform initiative—RAND COMPARE (Comprehensive Assessment of Reform Efforts)—provide objective research and analysis on topics that can inform the health care reform debate, including financing; increasing access, insurance coverage, and quality; decreasing costs; and promoting wellness and prevention.

Explore Health Care Reform

  • An elderly person's hands on a doctor's desk next to a stethoscope


    What Happens If the ACA's Tax Credits Are Replaced with Premium Support?

    As policymakers consider alternatives to reduce the federal government's financial burden from providing subsidies under the ACA, they should consider the consequences for enrollees. Existing premium-support models yield considerable savings for the federal government but could create age and income disparities in coverage.

    Nov 24, 2015

  • Crowd of people walking on a city street


    RAND American Life Panel

    The RAND American Life Panel (ALP) is a group of more than 5,000 individuals ages 18 and over who have agreed to participate in occasional online surveys.

    Nov 23, 2015

  • Patients waiting to see a doctor


    Insurance Enrollment Holds Steady in Advance of the 2016 Open Enrollment Period

    Since September 2013, the number of people with health insurance coverage has increased by 16.6 million. But since the second ACA open enrollment period in February 2015, the number of people with coverage has remained relatively flat. The third open enrollment period began on November 1. Whether the number of uninsured will continue to decline remains an open question.

    Nov 12, 2015

  • Woman's finger on a calculator with laptop and mouse in the background


    Can the Cadillac Tax Be Made Less Regressive by Replacing It with an Exclusion Cap? Methods and Results

    Examines the effects of the Affordable Care Act's Cadillac tax versus an alternative tax, based on an exclusion gap, on families in different income ranges.

    Oct 8, 2015

  • A senior man receives a consultation from his doctor


    Charging Older Adults Higher Premiums Could Cost Taxpayers

    Under the Affordable Care Act, older adults cannot be charged more than three times as much as 21- to 24-year-olds for the same plan. Changing this rule to 5-to-1 may not be a cost-effective way to encourage enrollment among the young and healthy.

    Sep 15, 2015

  • Report

    RAND Review: September-October 2015

    This issue of RAND Review reports on the staggering costs of dementia in the United States; the most critical global choices and challenges the next U.S. president will likely face; tips to protect the health of kids heading back to school; and more.

    Aug 21, 2015

  • Calculator and stethoscope on a spreadsheet


    The Ramifications of Repealing the Individual Mandate

    As part of its goal of near-universal coverage, the Affordable Care Act requires most Americans to obtain insurance or pay a penalty. Repealing that requirement would significantly reduce health insurance enrollment and cause individual market premiums to rise.

    Aug 13, 2015

  • Supporters of the Affordable Care Act celebrate after the Supreme Court ruled in favor of the Obama administration, Washington, DC, June 25, 2015


    Why Obamacare Lives

    Economic reasoning took center stage in the Supreme Court's decision on Thursday to uphold the legality of the Affordable Care Act's subsidies in all states. The subsidies are critical to ensuring that healthy people, with lower health care costs, have adequate incentive to enroll.

    Jun 26, 2015

  • Demonstrators hold signs showing the number of people they say could lose affordable health care in King v. Burwell, in front of the Supreme Court building, March 4, 2015


    What Americans Know About King v. Burwell

    An upcoming Supreme Court ruling regarding the Affordable Care Act could impact millions of Americans. Are Americans aware of the court case? And if so, what do they know about it?

    Jun 12, 2015

  • Research Brief

    How Does the ACA Individual Mandate Affect Enrollment and Premiums in the Individual Insurance Market?

    Describes how removing the Affordable Care Act's individual mandate would affect health insurance premiums and the overall numbered of insured.

    Jun 4, 2015

  • future-of-anticoagulation-initiative


    Joanna Chataway and John Camm Discuss the Pan-European Future of Anticoagulation Initiative

    RAND Europe’s Joanna Chataway and University of London Professor John Camm discuss the pan-European Future of Anticoagulation Initiative, its goals with regard to treating atrial fibrillation, RAND Europe's research process, and the team’s findings and recommendations.

    Jun 2, 2015

  • News Release

    Health Coverage Grows Under Affordable Care Act

    Insurance coverage has increased across all types of insurance since the major provisions of the federal Affordable Care Act took effect, with a net total of 16.9 million people becoming newly enrolled through February 2015.

    May 6, 2015

  • Report

    Insurance Transitions Following the First ACA Open Enrollment Period

    This report examines health insurance transitions between September 2013 and November 2014 using longitudinal data from the RAND Health Reform Opinion Study.

    May 6, 2015

  • Man with clipboard and laptop


    Methodology of the RAND Health Reform Opinion Study

    This report describes a methodology to track transitions in health insurance enrollment between November 2014 and December 2015.

    May 6, 2015

  • Report

    RAND's Impact in the Middle East

    Provides an overview of RAND's impact in the Middle East in the areas of supporting youth, health and health care, education, energy and environment, labor market reform and private-sector development, capacity-building, and planning for the future.

    Apr 29, 2015

  • Medical personnel gathered around a laptop

    Journal Article

    Using Research to Transform the Health Care System

    Using the knowledge base developed by health services research can stimulate innovative thinking about how to make health care systems safer, more efficient, more cost effective, and more patient centered.

    Apr 22, 2015

  • Barack Obama signing the Patient Protection and Affordable Care Act at the White House, March 23, 2010


    The Affordable Care Act in Depth

    In-depth exploration of the Affordable Care Act, with emphasis on related RAND Health research.

    Apr 8, 2015

  • Doctors reviewing an MRI

    Journal Article

    Medically Unnecessary Diagnostic Imaging: Emergency Physicians Weigh In

    A substantial proportion of advanced imaging studies ordered by emergency physicians may be medically unnecessary. According to a broad survey of emergency medicine professionals, fear of missing a low-probability diagnosis and fear of litigation are perceived as two key contributing factors.

    Apr 7, 2015

  • Doctor consulting with patient

    Journal Article

    Emergency Physician Perceptions of Shared Decision-Making

    Despite the potential benefits of shared decision-making (SDM), its integration into emergency care is challenging.

    Apr 7, 2015

  • American flag, stethoscope, and money

    Research Brief

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

    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?

    Apr 6, 2015

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