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, remains in force. But from its inception, the law has faced strong opposition.

Congress must decide whether to eliminate the ACA and replace it with a different system, or change the ACA to meet different political goals. 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 rate regulations, and essential health benefits. We have also explored effects of alternatives to the ACA, including a single payer system.

In a recent analysis, a health policy expert steps back to consider what the basic ingredients are for health care reform.

Read More About U.S. Health Care Policy Browse RAND Analyses of Health Care Legislation, Policies, and Proposals
  • Journal Article

    Dec 27, 2018

    Expanding Enrollment Without the Individual Mandate

    Recent changes to the Affordable Care Act, including the elimination of the individual mandate penalty, may reduce enrollment in the individual market. But even with these changes, options exist for increasing health coverage.

What's Hot Now

  • Report

    Integrating Department of Defense and Department of Veterans Affairs Purchased Care

    Nov 26, 2018

    The U.S. Department of Defense (DoD) and U.S. Department of Veterans Affairs (VA) both use private-sector contracts—known as "purchased care"—that govern how beneficiaries see community-based health providers. How feasible is it to integrate the VA and DoD approaches to purchased care?

  • Report

    Physicians Need Time to Adapt to Changing Payment Models

    Oct 24, 2018

    It is difficult for physicians to keep up with changing payment models, navigate complexity, and invest in data and reporting. Slowing the rate of change and simplifying payment models can help physicians improve patient care and earn financial benefits.

  • Journal Article

    Keeping Young Adults Insured Means More Mental Health Care

    Sep 21, 2018

    Lack of insurance has been a barrier to mental health treatment for young adults. The ACA's Dependent Care Expansion, which allows them to stay on their parents' policies until age 26, has increased use of mental health care among this high need group—without affecting quality of care or disparities in access.

  • Report

    Impacts of Eliminating the Individual Mandate Penalty in New York

    Sep 20, 2018

    In 2019, the ACA's individual mandate penalty will be eliminated. How will this affect New York's nongroup insurance market? It could result in an estimated 23 to 25 percent increase in premiums and a 37 percent reduction in enrollment.