Publications on the Patient Protection and Affordable Care Act

2017

• The Impact of Health Reform on Purchased Care Access: National Health Reform and Modernization of the Military Health System Study 2017

  Andrew W. Mulcahy, Italo A. Gutierrez, Tadeja Gracner, Teague Ruder, George E. Hart, Melony E. Sorbero

  The authors estimated how an influx of newly insured patients through the Affordable Care Act's coverage expansion may change the way that civilian providers choose to interact with the TRICARE program. The report culminates in lists and maps of counties where civilian physicians are most likely to face financial incentives to substitute newly insured patients for current TRICARE patients.

• Impact of the Affordable Care Act's Dependent Coverage Expansion on the Health Care and Health Status of Young Adults: What Do We Know So Far 2017

  Joshua Breslau, Bradley D. Stein, Bing Han, Shoshana R. Shelton, Hao Yu

  Under the ACA's dependent coverage expansion, there has been an increase in behavioral health treatment and a decrease in high out-of-pocket expenses and ER visits among young adults.

• Options to Expand Health Insurance Enrollment in the Individual Market 2017

  Christine Eibner, Jodi L. Liu

  Policymakers have many options to expand coverage in the individual market. We considered federal investments that would enhance, extend, or increase the tax credits available to enrollees, as well as reinsurance approaches that would lower premiums.

• Oregon's Options to Overhaul Health Care Financing: Health Care Reform 2.0? 2017

  Chapin White, Christine Eibner, Jodi L. Liu, Carter C. Price, Nora Leibowitz, Gretchen Morley, Jeanene Smith, Tina Edlund, Jack Meyer

  This analysis of three options to reform health care payment in Oregon (two state-based plans that would ensure coverage for all state residents and a state-sponsored plan offered in Oregon's nongroup market) found benefits and trade-offs for each.

• Patient Perceptions of Integrated Care and Their Relationship to Utilization of Emergency, Inpatient and Outpatient Services 2017

  Ashley-Kay Fryer, Mark W. Friedberg, Ryan W. Thompson, Sara J. Singer

  Patients who perceive their care to be integrated make less use of both emergency department and outpatient care.  

• Veterans' Health Insurance Coverage Under the Affordable Care Act and Implications of Repeal for the Department of Veterans Affairs 2017

  Michael Dworsky, Carrie M. Farmer, Mimi Shen

  This report describes the Affordable Care Act's (ACA's) effects on nonelderly veterans' insurance coverage and demand for Department of Veterans Affairs (VA) health care and assesses the coverage and VA utilization changes that could result from repealing the ACA.

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

  Evan Saltzman, Christine Eibner, Alain C. Enthoven

  Of three alternatives examined for expanding health insurance and lowering premiums with no additional federal spending, extending the Affordable Care Act's subsidies to all consumers and placing a floor on subsidies had the greatest benefit.

• Assessing the Role of State and Local Public Health in Outreach and Enrollment for Expanded Coverage: A Case Study on Houston, Texas 2016

  Laura Runnels, Kate Heyer, Courtney Armstrong, Malcolm V. Williams, Laurie T. Martin

  Part of a series highlighting innovative models and best practices for leveraging local health departments' involvement in Patient Protection and Affordable Care Act outreach and enrollment, this brief reports on a case study on Houston, Texas, that captures nuanced differences in how health departments support these efforts, identifies facilitators and barriers to these approaches, and develop lessons learned from these activities.

• Assessing the Role of State and Local Public Health in Outreach and Enrollment for Expanded Coverage: A Case Study on Tacoma–Pierce County, Washington 2016

  Nazleen Bharmal, Malcolm V. Williams, Laurie T. Martin, Christian Lopez

  Part of a series on innovative models and best practices for leveraging local health departments' involvement in Patient Protection and Affordable Care Act outreach and enrollment, this report describes a case study on Tacoma--Pierce County, Washington, that captures nuanced differences in how health departments support these efforts, identifies facilitators and barriers to these approaches, and develop lessons learned from these activities.

• Assessing the Role of State and Local Public Health in Outreach and Enrollment for Expanded Coverage: A Case Study on Boston and Massachusetts 2016

  Kate Heyer, Nazleen Bharmal, Laurie T. Martin, Malcolm V. Williams, Courtney Armstrong

  Part of a series highlighting innovative models and best practices for leveraging local health departments' involvement in Patient Protection and Affordable Care Act outreach and enrollment, this report describes a case study on Boston and Massachusetts that captures nuanced differences in how health departments support these efforts, identifies facilitators and barriers to these approaches, and develop lessons learned from these activities.

• Assessing the Role of State and Local Public Health in Outreach and Enrollment for Expanded Coverage: A Case Study on Eagle, Garfield, and Pitkin Counties, Colorado 2016

  Malcolm V. Williams, Laurie T. Martin, Nazleen Bharmal, Christian Lopez, Courtney Armstrong, Kate Heyer

  Part of a series highlighting innovative models and best practices for leveraging local health departments' involvement in Patient Protection and Affordable Care Act outreach and enrollment, this report is a case study on three Colorado counties that captures nuanced differences in how health departments support these efforts, identifies facilitators and barriers to these approaches, and develop lessons learned from these activities.

• Assessing the Role of State and Local Public Health in Outreach and Enrollment for Expanded Coverage: A Case Study on New Orleans, Louisiana 2016

  Malcolm V. Williams, Christian Lopez, Laurie T. Martin, Courtney Armstrong

  Part of a series highlighting innovative models and best practices for leveraging local health departments' involvement in Patient Protection and Affordable Care Act outreach and enrollment, this report describes a case study on New Orleans, Louisiana, that captures nuanced differences in how health departments support these efforts, identifies facilitators and barriers to these approaches, and develop lessons learned from these activities.

• Assessing the Role of State and Local Public Health in Outreach and Enrollment for Expanded Coverage: A Case Study on Illinois 2016

  Malcolm V. Williams, Laurie T. Martin, Christian Lopez, Courtney Armstrong

  Part of a series highlighting innovative models and best practices for leveraging local health departments' involvement in Patient Protection and Affordable Care Act outreach and enrollment, this brief reports on a case study on Illinois that captures nuanced differences in how health departments support these efforts, identifies facilitators and barriers to these approaches, and develop lessons learned from these activities.

• Assessing the Role of State and Local Public Health in Outreach and Enrollment for Expanded Coverage: Seven Case Studies from Local and State Health Departments 2016

  Malcolm V. Williams, Laurie T. Martin, Courtney Armstrong, Nazleen Bharmal, Julia Joh Elligers, Laura Runnels, Kate Heyer, Christian Lopez

  This report summarizes seven case studies to highlight innovative models and best practices from seven case studies that leverage local health department (LHD) efforts in Patient Protection and Affordable Care Act outreach and enrollment to facilitate knowledge transfer to other geographic regions. Also, they provide guidance and insight into the current and future role of LHDs, as states continue to enroll residents in health insurance coverage.

• Assessing the Role of State and Local Public Health in Outreach and Enrollment for Expanded Coverage: A Case Study on West Virginia 2016

  Julia Joh Elligers, Nazleen Bharmal, Laurie T. Martin, Malcolm V. Williams, Courtney Armstrong

  Part of a series highlighting innovative models and best practices for leveraging local health departments' involvement in Patient Protection and Affordable Care Act outreach and enrollment, this report describes a case study on West Virginia that captures nuanced differences in how health departments support these efforts, identifies facilitators and barriers to these approaches, and develop lessons learned from these activities.

• Child Poverty in the United States Today: Introduction and Executive Summary 2016

  Benard Dreyer, Paul J. Chung, Peter G. Szilagyi, Shale Wong

  This executive summary summarizes what is known about the scope of childhood poverty in the United States today, as well as its effects on health and well-being for U.S children.

• Consumer Decisionmaking in the Health Care Marketplace 2016

  Erin Audrey Taylor, Katherine Grace Carman, Andrea Lopez, Ashley N. Muchow, Parisa Roshan, Christine Eibner

  To understand how consumers make decisions and the extent to which various factors can hinder decisionmaking, RAND researchers reviewed the literature on health insurance choice and on designing websites to support consumers' choices and, where possible, gleaned best practices from the literature. To understand the approaches health insurance websites have taken to convey information to consumers, they then reviewed 20 websites.

• Demographic, Insurance, and Health Characteristics of Newly Enrolled HIV-positive Patients After Implementation of the Affordable Care Act in California 2016

  Derek D. Satre, Sujaya Parthasarathy, Andrea Altschuler, Michael Silverberg, Erik D. Storholm, Cynthia I. Campbell

  After key ACA provisions went into effect in 2014, enrollment of HIV-positive patients increased. Those newly enrolled in a large California health plan were more likely to be male, in a high-deductible plan, and to have better viral control.

• Donald Trump's Health Care Reform Proposals: Anticipated Effects on Insurance Coverage, Out-of-Pocket Costs, and the Federal Deficit 2016

  Evan Saltzman, Christine Eibner

  The Trump health care proposal would decrease the number of insured and increase consumer health spending among those with marketplace insurance relative to current law. The policies would also increase the federal deficit by varying amounts.

• The Effect of the 2014 Medicaid Expansion on Insurance Coverage for Newly Eligible Childless Adults 2016

  Michael Dworsky, Christine Eibner

  The authors used the National Health Interview Survey (NHIS) to estimate how the Affordable Care Act Medicaid expansion affected health insurance enrollment, by source of coverage, among childless adults who became newly eligible for Medicaid in 2014. The NHIS data allowed the authors to report changes in enrollment by source of coverage and to conduct subgroup analyses of Medicaid take-up by gender, age, and other characteristics.

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