Over one-third of states appear to have more stringent medical privacy laws than HIPAA (federal), which could hinder primary care and mental health providers' efforts to share information and integrate care.
Despite their differences, the Affordable Care Act and the current proposals to replace it take a similar approach to providing health insurance. What might some alternatives look like? And how could they provide coverage to more Americans?
The U.S. health care policy landscape is poised for great change. Extensive RAND research offers insights about the likely impact of repealing or revising the ACA along key dimensions, including Medicaid, the individual mandate, effects on employers, tax subsidies, changing rating regulations, and essential health benefits.
The American Health Care Act would guarantee that individuals with pre-existing conditions could enroll in insurance even if they had a coverage lapse. But there is no guarantee that this coverage would be affordable, and coverage of some essential health benefits could be excluded.
The American Health Care Act passed by the U.S. House of Representatives to repeal and replace the Affordable Care Act allows states to waive benefits that the ACA deemed “essential.” Dropping maternity care coverage, for example, would reduce premiums by 5 percent but increase out-of-pocket spending for new mothers.
Christine Eibner, a senior economist who has led influential work on how to improve the nation's health care system, has been appointed to the RAND Corporation's Paul O'Neill Alcoa Chair in Policy Analysis.
The American Health Care Act would have reduced insurance enrollment by an estimated 14.2 million people in 2020 and by 19.7 million people by 2026. The uninsured would have been older, sicker, and poorer than those currently uninsured. Also, the AHCA would have increased the deficit by $38 billion in 2020 while reducing it by $5 billion in 2026.
Medicaid enrollees are less likely than those with private insurance to see a dermatologist or receive care for a skin condition, suggesting that efforts need to be made to increase access to skin specialists.
Doctors recommend exclusive breastfeeding for the first six months of a baby's life. This provides health benefits to both mother and child and saves health care costs. Paid maternity leave can boost breastfeeding rates, but few U.S. firms offer it.
The Medicare Access and Chip Reauthorization Act (MACRA) will decrease Medicare spending on physician services by an estimated -$35 to -$106 billion and change spending on hospital services by +$32 to -$250 billion between 2015 and 2030.
RAND researchers examined stakeholder experiences with an Affordable Care Act provision that qualifying providers of primary care services participating in the Medicaid program would receive enhanced federal payments for providing certain services.
Patients treated for acute respiratory infections by a doctor on a telephone or live video are as likely to be prescribed an antibiotic as those treated in person. However, patients treated virtually are more often prescribed a broad-spectrum antibiotic, which is concerning because overuse of the drugs increases costs and contributes to antibiotic resistance.