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.
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Browse RAND Analyses of Health Care Legislation, Policies, and Proposals
Aug 10, 2018
Starting in 2019, the Affordable Care Act's individual mandate penalty will be eliminated, effectively ending the law's requirement that most people have health insurance. While declines in coverage and increases in premiums are likely, the magnitudes of these effects are highly uncertain.
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Removing the financial penalties associated with the Affordable Care Act's individual mandate may cause enrollment to fall by 2.8 million to 13 million people. It could also result in a 3 to 13 percent increase in bronze plan premiums.
The ACA policy change requiring most private health insurance plans to cover lactation-support services and breastfeeding equipment (without cost-sharing) was associated with a 10% increase in length of breastfeeding and a 21% increase in the length of exclusive breastfeeding.
Increasing prevention and treatment improves children's experience and long-term outcomes while paying for itself by reducing lifetime child welfare system costs.
Policies aimed at increasing prevention and kinship care in the child welfare system improve children's experience and long-term outcomes. This approach is also cost effective, reducing total spending by 3 to 7 percent.