U.S. Health Care Policy

The U.S. health care system is in flux. The Patient Protection and Affordable Care Act (ACA), enacted in 2010, was an effort to enact a comprehensive national health policy. The law’s main goal was to improve access to health care by creating individual insurance markets where consumers could buy coverage directly from insurers and by expanding access to Medicaid. The law has reduced the number of uninsured, particularly in states that expanded Medicaid. However, from its inception, the ACA has faced strong political opposition and numerous legal challenges.

In recent years, Congress has debated whether to eliminate the ACA and replace it with a different system, or change the ACA to meet diverse policy goals. Extensive RAND research offers insights about the likely impact of repealing or revising the ACA along key dimensions, including Medicaid, the individual mandate (which was repealed by Congress in 2018), tax subsidies in the individual market, and essential health benefits. RAND work has also explored the effects of alternatives to the ACA, including a single-payer system.

Read More About U.S. Health Care Policy Browse RAND Analyses of Health Care Legislation, Policies, and Proposals
  • A patient sitting on an MRI machine talking to a medical professional, photo by laflor/Getty Images


    Nov 18, 2019

    Medicare for 50-to-64-Year-Olds

    Allowing Americans aged 50 to 64 to buy into Medicare would lower health care premiums for the group. But it would also drive up costs for younger people who buy health insurance on Affordable Care Act exchanges.

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