Sarah A. Nowak

Overview

Commentary

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  Estimates of COVID-19's Fatality Rate Might Change. And Then Change Again.

  With infections of the new coronavirus confirmed in countries around the world, people are following the daily tally of COVID-19 cases, wondering exactly how lethal this new disease is. The truth is, it's hard to know.

  Mar 11, 2020 The RAND Blog

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  All Health Policy Is Local: The Case of the Individual Mandate Penalty in New York

  As with many Affordable Care Act policies, how New York is dealing with the absence of the individual mandate penalty is a potent reminder that all health policy is local.

  Oct 30, 2018 The Health Care Blog

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  Understanding the Impact of the Elimination of the Individual Mandate Penalty

  Starting in 2019, the Affordable Care Act's individual mandate penalty will be eliminated, effectively ending the law's requirement that most people have health insurance. While declines in coverage and increases in premiums are likely, the magnitudes of these effects are highly uncertain.

  Aug 10, 2018 The Commonwealth Fund Blog

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  Modifying the ACA's Family Subsidy Rules to Help Ensure Affordability

  The ACA encourages workers to retain employer coverage by restricting their eligibility for marketplace subsidies. Modifying the policy could help 700,000 people gain coverage and lower spending for 1.6 million who are insured but face high health care costs under current ACA policy.

  Jan 12, 2016 The Commonwealth Fund Blog

Publications

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  Research Brief

  Effects of a Public Option on Health Insurance Costs and Coverage

  This brief describes how a public option for health care—that is, a government-sponsored health insurance plan with publicly determined provider payment rates—would affect insurance costs and coverage.

  May 28, 2020

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  Report

  Public Options for Individual Health Insurance: Assessing the Effects of Four Public Option Alternatives

  There is growing interest in a "public option" for individual market insurance to improve affordability and enrollment. The authors estimate how adding a federal public option could affect enrollment, premiums, and government spending.

  May 28, 2020

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  Research Brief

  How the U.S. Coast Guard Can Leverage Social Media and Enhanced Cell Phone Data to Improve Emergency Response

  Researchers are helping the U.S. Department of Homeland Security understand how social media might be better leveraged for situational awareness—particularly location information—in U.S. Coast Guard response operations.

  Mar 17, 2020

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  Report

  U.S. Coast Guard Emergency Response and Disaster Operations: Using Social Media for Situational Awareness

  Researchers are helping the U.S. Department of Homeland Security understand whether and how social media might be better leveraged for situational awareness in U.S. Coast Guard response operations.

  Mar 17, 2020

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  Report

  Medicare for 50-to-64-Year-Olds: Assessing the Effects of Allowing Older Adults to Buy Into the Medicare Program

  In this report, the authors analyze how allowing adults ages 50 and older to buy into the Medicare program could affect health insurance coverage, individual market premiums, and federal health care spending.

  Nov 18, 2019

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  Report

  Options for Reinvesting Savings from Restored Federal Cost-Sharing Reduction Payments: Examining the Effects of Two Policy Alternatives on Spending and Enrollment in the Individual Health Insurance Market

  The authors of this report examine the impact of providing additional health insurance subsidies or financing reinsurance from the savings resulting from restored federal cost-sharing reduction payments to insurers under the Affordable Care Act.

  Sep 10, 2019

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  Report

  Effects of Alternative Insurer Responses to Discontinued Federal Cost-Sharing Reduction Payments: Broad Loading as an Alternative to Silver Loading

  In this report, the authors assess the effects of disallowing the current practice of increasing only the premiums of silver-tiered individual market plans in response to discontinued federal payments of cost-sharing reductions (silver loading).

  Jun 3, 2019

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  Report

  Impacts of the Elimination of the ACA's Individual Health Insurance Mandate Penalty on the Nongroup Market in New York State

  How will elimination of the Affordable Care Act's individual mandate penalty affect the nongroup insurance market in the state of New York? Researchers used RAND's COMPARE microsimulation model to estimate the effects.

  Sep 20, 2018

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  Report

  An Assessment of the New York Health Act: A Single-Payer Option for New York State

  This report assesses how the state-sponsored single-payer health program New York Health would affect health care utilization and costs in New York, estimating its effects on key outcomes and comparing them with future outcomes under the status quo.

  Aug 1, 2018

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  Research Brief

  Estimating the Effects of a Single-Payer Proposal in New York State

  The New York Health Act could expand insurance coverage in New York without increasing overall health spending, if administrative costs are reduced and growth in provider payment rates is restrained. The program would be financed by new taxes.

  Aug 1, 2018

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  Journal Article

  The Effect of Eliminating the Individual Mandate Penalty and the Role of Behavioral Factors

  Under alternative assumptions about consumer responses, we find that enrollment falls by 2.8 million to 13 million people nationwide and premiums for bronze plans increase by 3 percent to 13 percent when the mandate penalty is removed.

  Jul 12, 2018

• Journal Article

  Journal Article

  What Is the Impact on Enrollment and Premiums If the Duration of Short-Term Health Insurance Plans Is Increased?

  Extending the duration of short-term individual health plans will have little effect on premiums or enrollment in the individual market.

  Jun 14, 2018

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  Report

  Increasing Cost-Effective Readiness for the U.S. Air Force by Reducing Supply Chain Variance: Technical Analysis of Flying Hour Program Variance

  Seeking to reduce the $4 billion that it spends annually on spare parts, the Air Force asked RAND researchers to identify the causes and gauge the effects of flying hour variance (the difference between predicted and actual numbers of flying hours).

  Apr 10, 2018

• Journal Article

  Journal Article

  Linking Reminders and Physician Breast Cancer Screening Recommendations: Results From a National Survey

  Physicians are more likely to recommend mammograms when they are reminded to do so, despite variation in how much they trust mammogram guidelines.

  Dec 18, 2017

• Journal Article

  Journal Article

  Association Between Physicians' Experiences With Members of Their Social Network and Efforts to Reduce Breast Cancer Screening

  Helping clinicians reflect on how their experiences influence their current screening patterns may be an important approach to improving their adherence to revised breast cancer screening guidelines.

  Dec 7, 2017

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  Report

  The Effects of Iowa's Proposed Stopgap Measure on Health Insurance Costs and Coverage

  This report uses RAND's COMPARE microsimulation model to estimate the effects of a 1332 waiver application from the state of Iowa. The waiver is designed to stabilize Iowa's Affordable Care Act individual market through a series of modifications.

  Oct 17, 2017

• Journal Article

  Journal Article

  Physician Breast Cancer Screening Recommendations Following Guideline Changes: Results of a National Survey

  Physicians' recommendations for when to start and end breast cancer screening vary, depending on their level of trust with the guideline-issuing organization.

  May 23, 2017

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  Report

  The Effects of the American Health Care Act on Health Insurance Coverage and Federal Spending in 2020 and 2026

  The authors used RAND's COMPARE microsimulation model to analyze the American Health Care Act, a bill proposed in the U.S. House of Representatives on March 6, 2017, that would have repealed and replaced many provisions of the Affordable Care Act.

  May 3, 2017

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  Report

  A General Agent-Based Model of Social Learning

  This report describes a general agent-based model (ABM) for studying social learning, and uses that general ABM to explore the relationship between micro-influence and macro-dynamics for broad classes of problems.

  Mar 31, 2017

• Journal Article

  Journal Article

  Hillary Clinton's Health Care Reform Proposals: Anticipated Effects on Insurance Coverage, Out-of-Pocket Costs, and the Federal Deficit

  The Clinton health care proposal would increase the number of insured individuals and decrease consumers' health spending relative to current law. However, the policies with the largest coverage gains also increase the federal deficit the most.

  Nov 4, 2016

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  Report

  Private Health Insurance Exchanges: Early Evidence and Implications for the Future

  This report examines how private employer health exchanges function, how they may affect employers and employees, and the possible implications for the Affordable Care Act's Small Business Health Options Program Marketplaces.

  May 9, 2016

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  Report

  The RAND Health Care Payment and Delivery Simulation Model (PADSIM): Concepts, Methods, and Examples

  This report describes RAND's Health Care Payment and Delivery Simulation Model (PADSIM), developed to more effectively analyze the impacts of current and future reforms to provider payment policy.

  Mar 22, 2016

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  Journal Article

  Evaluating the CARE Act: Implications of a Proposal to Repeal and Replace the Affordable Care Act

  Policymakers seeking to adopt the CARE Act, or to pursue a similar repeal-and-replace policy, may need to maintain some of the ACA's revenue-generating provisions, adopt alternative revenue-generating provisions, or reduce the generosity of tax credits to achieve budget neutrality.

  2016

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  Report

  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

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  Report

  Alternatives to the ACA's Affordability Firewall

  This report examines policy impacts of the Affordable Care Act's "affordability firewall," which limits subsidies to individuals lacking access to alternative sources of coverage that are "affordable," and investigates two potential modifications.

  Oct 5, 2015

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  Report

  The Economic Incidence of Health Care Spending in Vermont

  Estimates the economic incidence of health spending in the state of Vermont for 2012 and as projected for 2017.

  Jan 8, 2015

• Journal Article

  Journal Article

  Social Network Effects of Nonlifesaving Early-Stage Breast Cancer Detection on Mammography Rates

  We estimated the effect of anecdotes of early-stage, screen-detected cancer for which screening was not lifesaving on the demand for mammography.

  2014

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  Research Brief

  Will the Affordable Care Act Make Health Care More Affordable?

  For most lower-income people who obtain coverage as a result of the Affordable Care Act, health care spending will fall. But spending by some newly insured higher-income people will increase because they will be now paying insurance premiums.

  Dec 11, 2013

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  Report

  Assessment of the Air Force Materiel Command Reorganization: Report for Congress

  Assesses the FY 2012 reorganization of the Air Force Material Command, which was undertaken as one of the initiatives to achieve mandated budget reductions by eliminating civilian manpower positions, thus achieving cost savings.

  Nov 21, 2013

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  Report

  Effects of the Affordable Care Act on Consumer Health Care Spending and Risk of Catastrophic Health Costs

  This study examines likely effects of the Affordable Care Act on average annual consumer health care spending and risk of catastrophic medical costs and considers how these outcomes are affected by state decisions to expand Medicaid.

  Oct 1, 2013

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  Report

  The Affordable Care Act and Health Insurance Markets: Simulating the Effects of Regulation

  The authors estimate the effects of the Affordable Care Act on health insurance enrollment and premiums for ten states and for the nation overall, with a focus on outcomes in the nongroup and small group markets.

  Aug 29, 2013

• Report

  Report

  Sustaining the U.S. Air Force Nuclear Mission

  This report proposes a double-layered framework for efficiently integrating and managing the sustainment activities of the U.S. Air Force nuclear enterprise in the face of reduced funding and a smaller force structure.

  Jul 31, 2013

• Journal Article

  Journal Article

  The COMPARE Microsimulation Model and the U.S. Affordable Care Act

  In anticipation of upcoming health care legislation, the RAND Corporation developed a microsimulation model to forecast the responses of individuals, families and firms to such legislation.

  2013

• Research Brief

  Research Brief

  How Will Health Care Reform Affect Costs and Coverage? Examples from Five States

  Projects how the coverage-related provisions of the Patient Protection and Affordable Care Act will affect health insurance coverage and state government spending on health care in five states.

  Apr 1, 2011

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  Report

  The Impact of the Coverage-Related Provisions of the Patient Protection and Affordable Care Act on Insurance Coverage and State Health Care Expenditures in Illinois: An Analysis from RAND COMPARE

  Projects how the coverage-related provisions of the Patient Protection and Affordable Care Act will affect health insurance coverage and state government spending on health care in Illinois through 2020.

  Apr 1, 2011

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  Report

  The Impact of the Coverage-Related Provisions of the Patient Protection and Affordable Care Act on Insurance Coverage and State Health Care Expenditures in Texas: An Analysis from RAND COMPARE

  Projects how the coverage-related provisions of the Patient Protection and Affordable Care Act will affect health insurance coverage and state government spending on health care in Texas through 2020.

  Apr 1, 2011

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  Report

  The Impact of the Coverage-Related Provisions of the Patient Protection and Affordable Care Act on Insurance Coverage and State Health Care Expenditures in California: An Analysis from RAND COMPARE

  Projects how the coverage-related provisions of the Patient Protection and Affordable Care Act will affect health insurance coverage and state government spending on health care in California through 2020.

  Apr 1, 2011

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  Report

  The Impact of the Coverage-Related Provisions of the Patient Protection and Affordable Care Act on Insurance Coverage and State Health Care Expenditures in Montana: An Analysis from RAND COMPARE

  Projects how the coverage-related provisions of the Patient Protection and Affordable Care Act will affect health insurance coverage and state government spending on health care in Montana through 2020.

  Apr 1, 2011

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  Report

  The Impact of the Coverage-Related Provisions of the Patient Protection and Affordable Care Act on Insurance Coverage and State Health Care Expenditures in Connecticut: An Analysis from RAND COMPARE

  Projects how the coverage-related provisions of the Patient Protection and Affordable Care Act will affect health insurance coverage and state government spending on health care in Connecticut through 2020.

  Apr 1, 2011