The National Adult Immunization Plan: Strengthening Adult Immunization Through Coordinated Action 2017
Addressing persistent structural and policy barriers to adult immunization will benefit all Americans.
Publications on the Patient Protection and Affordable Care Act
2017
2016
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Financial Loss for Inpatient Care of Medicaid-insured Children 2016
Medicaid financial losses at children's hospitals greatly exceed losses at other types of hospitals.
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Gaining Coverage Through Medicaid or Private Insurance Increased Prescription Use and Lowered Out-of-Pocket Spending 2016
A growing body of literature describes how the Affordable Care Act (ACA) has expanded health insurance coverage. What is less well known is how these coverage gains have affected populations that are at risk for high health spending.
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Health Insurance and Workers' Compensation Claiming: Evidence from the Affordable Care Act 2016
Exploits the Affordable Care Act young adult dependent coverage expansion to measure the effect of health coverage expansions on workers' compensation claim frequency and severity.
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Hillary Clinton's Health Care Reform Proposals: Anticipated Effects on Insurance Coverage, Out-of-Pocket Costs, and the Federal Deficit 2016
The Clinton health care proposal would increase the number of insured individuals and decrease consumers' health spending relative to current law. However, the policies with the largest coverage gains also increase the federal deficit the most.
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How Does Expanding Health Insurance Coverage Affect Workers' Compensation Costs? 2016
The Affordable Care Act's expansion of coverage for people under age 26 led to a 1-percent reduction in uninsurance, equating to a 0.8-percent decrease in workers' compensation claim frequency, and a roughly 1-percent decrease in overall claim costs.
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Knowledge as a Predictor of Insurance Coverage Under the Affordable Care Act 2016
People who do not understand health insurance concepts, or the financial concepts associated with health insurance, are more likely to remain uninsured.
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Lactation Support Services and Breastfeeding Initiation: Evidence from the Affordable Care Act 2016
The likelihood that mothers with private health insurance would start breastfeeding increased by 2.5 percentage points after the Affordable Care Act mandated the coverage of lactation support services.
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Medical Device Innovation in the Era of the Affordable Care Act: The End of Sexy 2016
In this Perspective, the authors explore why medical device innovation has traditionally focused on improving performance, with little regard to cost. They argue that new incentives in the health care sector, accelerated by the Affordable Care Act, will force device manufacturers to embrace "the end of sexy" and redirect investments from the spectacular toward the prudent. They explore consequences for manufacturers, investors, and policymakers.
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Private Health Insurance Exchanges: Early Evidence and Implications for the Future 2016
Private exchanges offer employer health insurance, combining online shopping, increased plan choice, benefit administration, and cost-containment strategies. This report examines how private exchanges function, how they may affect employers and employees, and the possible implications for the Affordable Care Act's Small Business Health Options Program Marketplaces.
2015
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Affordable Care Act Provision Lowered Out-of-Pocket Cost and Increased Colonoscopy Rates Among Men in Medicare 2015
Colorectal cancer screening is one of the few cancer screenings with an A rating from the US Preventive Services Task Force, meaning that the procedure confers a substantial health benefit.
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Alternatives to the ACA's Affordability Firewall 2015
The Affordable Care Act implements the employer mandate, which requires firms with more than 50 employees to offer health insurance or face penalties, and the individual "affordability firewall," which limits subsidies to individuals lacking access to alternative sources of coverage that are "affordable." This report examines the policy impacts of the affordability firewall and investigates two potential modifications.
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Can the Cadillac Tax Be Made Less Regressive by Replacing It with an Exclusion Cap? Methods and Results 2015
The Affordable Care Act's "Cadillac tax" consists of a 40-percent excise tax on premiums for employer-sponsored health plans in excess of a dollar limit. This report uses RAND's COMPARE microsimulation model to compare the effects of the Cadillac tax versus an alternative tax, based on an exclusion gap, on families in different income ranges.
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Comparing Employer-Sponsored and Federal Exchange Plans: Wide Variations in Cost Sharing for Prescription Drugs 2015
Our primary objective was to examine the variability in drug coverage in the exchanges across plan types (health maintenance organization or preferred provider organization) and metal tiers (bronze, silver, gold, and platinum).
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Connecting Consumers to Care 2015
The Affordable Care Act has reduced the number of uninsured; an emerging challenge is to help the newly insured choose coverage wisely and use it to access primary care and preventive services.
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Early Marketplace Enrollees Were Older and Used More Medication Than Later Enrollees: Marketplaces Pooled Risk 2015
Little is known about the health status of the 7.3 million Americans who enrolled in insurance plans through the Marketplaces established by the Affordable Care Act in 2014.
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The Economic Incidence of Health Care Spending in Vermont 2015
This report describes who ultimately pays for health care in Vermont by tracing spending back to the original funding source. The authors estimate the economic incidence of health spending in Vermont for 2012 and as projected for 2017.
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The Effect of Eliminating the Affordable Care Act's Tax Credits in Federally Facilitated Marketplaces 2015
In this research report, RAND Corporation researchers assess the expected change in enrollment and premiums in the Patient Protection and Affordable Care Act–compliant individual market in federally facilitated marketplace (FFM) states if the U.S. Supreme Court decides to eliminate subsidies in FFM states.
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Effects of Health Care Payment Models on Physician Practice in the United States 2015
The project reported here aimed to describe the effects that alternative health care payment models have on physicians and physician practices in the United States. Project findings should help guide efforts to improve current and future alternative payment programs and help physician practices succeed in these new payment models. The report provides both findings and recommendations.
2014
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The Affordable Care Act: An Opportunity for Improving Care for Substance Use Disorders? 2014
The ACA expands coverage for substance use treatment, but provides no measures for assessing its quality.