The U.S. health insurance model frequently costs more and provides less care than systems in other Western nations. RAND's health insurance research began in 1971 with the 15-year Health Insurance Experiment, the only community-based experimental study of how cost-sharing arrangements affect people’s use of health services, their quality of care, and their health status. Subsequent research has continued to inform the U.S. policy debate.
Amid mounting political pressure and angst in the business community, the Obama administration announced an additional delay in enforcing the employer mandate component of the Affordable Care Act for some firms until 2016. The additional delay will have little impact.
Everyone should take the time to ask themselves what they can do to improve their health, and to support the health of friends, families, and communities. When it comes to good health, it takes a community.
The vision of the ACA was “no wrong door” and an affordable option for everyone, but it appears based on the data available so far that, in the non-Medicaid expansion states, there is a closed door.
As the ACA is implemented, policy makers should be attuned to potential inefficiencies and inequities created by a system with different regulatory and tax rules for small employers, large employers, and individual health plans. Attempts to equalize the playing field may be difficult.
If Congress wants to save Medicare, it can start by driving waste and excess out of the system. This can be done without impoverishing patients or driving doctors out of business, if physicians are willing to practice smarter, more efficient medicine. Spending on prescription drugs is a case in point.
David Mastio, Forum editor at USA TODAY, asked RAND's Christine Eibner four questions about President Obama's plan to fix the problem with people getting their insurance canceled.
The Affordable Care Act (ACA) expands coverage to millions of Americans. But the newly eligible may face challenges enrolling if they lack understanding of how the health care system itself works. Laurie Martin explains the role of health literacy in determining how successful the ACA will be in providing coverage for America's uninsured.
Expanding Medicaid under the Affordable Care Act (ACA) is both contentious and complicated. RAND mathematician Carter Price has been using the COMPARE model to help those making decisions understand what their choices mean for their budgets and population health.
One of the chief aims of the Affordable Care Act (ACA) is the expansion of insurance coverage to individuals who at present either cannot afford it or choose not to purchase it. Unfortunately, many Americans lack the financial literacy needed to navigate the numerous and complex options thrust upon them by the ACA.
Out-of-pocket spending on health care will decrease for both the newly insured as well as for those changing their source of insurance. These decreases will be largest for those who would otherwise be uninsured.
The growing number of Americans newly-insured under the ACA will undoubtedly lead to a surge in demand for care, whether through Medicaid or insurance exchanges. But, if predictions hold, the increase won't be as dramatic as some may fear, writes David I. Auerbach.
The bottom line is that the employer mandate does not provide a large inducement for firms to change their health insurance offerings, but it does raise a substantial amount of money to pay for the ACA's coverage provisions over time.
Resolving the question of whether or not the U.S. has finally gotten a handle on health care spending is vitally important, because the choices we make going forward will have profound implications for our economy, the financial wellbeing of millions of American families, and ultimately America's standing in the world.
Because of the ACA's regulations, some smaller employers with young and healthy workers are considering avoiding the purchase of health care coverage in the regulated market, opting instead to self-insure their employees.
While a governor or legislator may disagree with Medicaid expansion for philosophical reasons, the claims that the expansion will be a burden on states' economies seem misguided given the full range of projected economic impacts on the states, writes Carter C. Price.
Multistate plans are most likely to appeal to out-of-state students, interstate migrants, out-of-state workers, seasonal movers (e.g., “snowbirds”), and similar groups that require improved access to health care across state lines.
At a time when our country is teetering on the edge of a “fiscal cliff,” no challenge in health care is more important than reducing health care spending, writes Arthur L. Kellermann.
Unfortunately, nearly every actor in our health care delivery system—hospitals, physicians, other health care providers, insurance companies and the manufacturers of drugs and devices—is currently focused on maximizing revenue growth, write Arthur Kellermann and David Auerbach.
A problem with using surveys to predict behavior is that they measure employer sentiment toward the ACA today, rather than the economic decisions employers typically make when the time comes, writes Art Kellermann.
If the individual mandate were ruled unconstitutional, subsidies and the age structure of premiums should keep enough healthy people in the insurance exchanges to prevent huge spikes in premiums, write Carter C. Price and Christine Eibner.