May 28, 2020
The Patient Protection and Affordable Care Act (ACA)—aka Obamacare—was intended to reduce the number of uninsured, make coverage more affordable, and expand access to care. The Act expanded eligibility for Medicaid and created new market places where people without employer coverage could buy policies direction from insurers.
The ACA also mandated new approaches to reducing costs and improving quality, including reducing payments to hospitals for some Medicare services and experimenting with new payment and delivery models. To understand the impact of these features and to monitor the overall effects of the ACA, RAND used COMPARE, a microsimulation model that allows us to estimate how proposed changes will affect key outcomes, including health coverage, employer-based insurance, consumer costs, and government spending.
RAND continues to use COMPARE to assess proposed revisions to the ACA. We also use a complementary model—Health Care Payment and Delivery Simulation Model (PADSIM)—to better understand provider responses to changes in payment policy.The Affordable Care Act in Depth