Health Care Policy Analysis

RAND continues to use COMPARE to assess proposed revisions to the ACA, other health care legislation, and proposals to replace 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.

Analysis of AHCA and Other Legislation and Proposals

• Effects of the American Health Care Act on Health Insurance Coverage and Federal Spending in 2020 and 2026 (2017)
• How the House-passed Bill Would Affect People with Pre-Existing Conditions (2017)
• Impact of Excluding Maternity Care, Mental Health, and Prescription Drugs from Essential Health Benefits (2017)
• Donald Trump's Health Care Reform Proposals: Anticipated Effects on Insurance Coverage, Out-of-Pocket Costs, and the Federal Deficit (2016)
• Hillary Clinton's Health Care Reform Proposals: Anticipated Effects on Insurance Coverage, Out-of-Pocket Costs, and the Federal Deficit (2016)

Effects of the ACA

• Did the Affordable Care Act's Dependent Coverage Expansion Affect Race/Ethnic Disparities in Health Insurance Coverage? (2017)
• The Effect of the 2014 Medicaid Expansion on Insurance Coverage for Newly Eligible Childless Adults (2016)
• Gaining Coverage Through Medicaid or Private Insurance Increased Prescription Use and Lowered Out-of-Pocket Spending (2016)
• Lactation Support Services and Breastfeeding Initiation: Evidence from the Affordable Care Act (2016)
• Consumer Decisionmaking in the Health Care Marketplace (2016)
• Private Health Insurance Exchanges: Early Evidence and Implications for the Future (2016)
• Insurance Transitions Following the First ACA Open Enrollment Period (2015)
• Early Marketplace Enrollees Were Older and Used More Medication Than Later Enrollees: Marketplaces Pooled Risk (2015)
• How Does the ACA Individual Mandate Affect Enrollment and Premiums in the Individual Insurance Market? (2015)
• Trends in Health Insurance Enrollment, 2013-15 (2015)
• How Do ACA Tax Subsidies Affect Premiums and Enrollment? (2015)
• How Does Enrollment of Young Invincibles Affect Premiums in the ACA Individual Market? (2015)
• The ACA’s Tax Credits Keep Premiums Low for Everyone (2014)
• Premiums and Stability in the Individual Health Insurance Market: The Effects of Young Adult Enrollment and Subsidies (2014)
• Changes in Health Insurance Enrollment Since 2013: Evidence from the RAND Health Reform Opinion Study (2014)
• Modeling the Effects of the Affordable Care Act in Arkansas (2013)
• Effects of the Affordable Care Act on Consumer Health Care Spending and Risk of Catastrophic Health Costs (2013)
• The Affordable Care Act and Health Insurance Markets: Simulating the Effects of Regulation (2013)
• Small Firms' Actions in Two Areas, and Exchange Premium and Enrollment Impact (2012)
• Employer Self-Insurance Decisions and the Implications of the Patient Protection and Affordable Care Act as Modified by the Health Care and Education Reconciliation Act of 2010 (ACA) (2011)

ACA Options and Modifications

• Repeal, Replace, Repair, or Improve? The Future of the ACA (2017)
• Repeal and Delay Would Make Budget Neutrality for ACA Replacement Difficult (2017)
• Alternatives to the ACA’s Affordability Firewall (2016)
• Insuring Younger Adults Through the ACA’s Marketplaces: Options to Expand Enrollment (2016)
• Assessing Policy Options for Subsidies to Improve the Affordable Care Act: One Approach Could Insure More People, Reduce Premiums, and Save $14 Billion per Year (2016)
• Modifying the ACA’s Family Subsidy Rules to Help Ensure Affordability (2016)
• The Affordable Care Act: An Opportunity for Improving Care For Substance Use Disorders? (2015)
• Can the Cadillac Tax Be Made Less Regressive by Replacing It with an Exclusion Cap? Methods and Results (2015)
• What Happens if the ACA’s Tax Credits are Replaced with Premium Support? (2015)
• Improving the Affordable Care Act: An Assessment of Policy Options for Providing Subsidies (2015)
• Harnessing Private-Sector Innovation to Improve Health Insurance Exchanges (2015)
• Can the Cadillac Tax Be Made Less Regressive by Replacing It with an Exclusion Cap? Methods and Results (2015)
• How Would Alternative Subsidy Structures Affect Stability in the ACA Individual Market? (2015)
• More Choice in Health Insurance Marketplaces May Reduce the Value of the Subsidies Available to Low-Income Enrollees (2015)
• The Effect of Eliminating the Affordable Care Act's Tax Credits in Federally Facilitated Marketplaces (2015)
• Assessing Alternative Modifications to the Affordable Care Act: Impact on Individual Market Premiums and Insurance Coverage (2014)
• Premiums and Stability in the Individual Health Insurance Market: The Effects of Young Adult Enrollment and Subsidies (2014)
• Evaluating the "Keep Your Health Plan Fix": Implications for the Affordable Care Act Compared to Legislative Alternatives (2014)
• Major Changes to Medicare Would Cut Costs but Also Squeeze Enrollment and Raise Spending for Seniors (2013)
• The Effect of the Affordable Care Act on Enrollment and Premiums, With and Without the Individual Mandate (2012)
• How Would Eliminating the Individual Mandate Affect Health Coverage and Premium Costs? (2012)
• How Will Health Care Reform Affect Costs and Coverage? Examples from Five States (2011)

State-Specific Analyses

• A Comprehensive Assessment of Four Options for Financing Health Care Delivery in Oregon (2017)
• Oregon's Options to Overhaul Health Care Financing: Health Care Reform 2.0? (2017)
• The Economic Incidence of Health Care Spending in Vermont (2015)
• How the Commonwealth of Pennsylvania May Fare Under the Affordable Care Act (2013)
• The Budgetary Effects of Medicaid Expansion on Pennsylvania: An Expansion on Previous Work (2013)
• The Economic Impact of Medicaid Expansion on Pennsylvania (2013)
• 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 (2011)
• 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 (2011)
• 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 (2011)
• 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 (2011)
• 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 2011
• How Will Health Care Reform Affect Costs and Coverage? Examples from Five States (2011)