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 25, 2017
Congress will soon discuss options to stabilize the individual market and ensure that all Americans have access to affordable coverage. Policymakers could encourage enrollment, make targeted investments to lower premiums, fund cost-sharing reductions, and enforce the individual mandate.
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Recent congressional proposals to repeal and replace the Affordable Care Act would increase the number of uninsured nonelderly veterans and further increase demand for VA health care. The effects would vary across states, but the largest impacts would be felt in states that expanded Medicaid.
The American Health Care Act would increase uninsurance among veterans and demand for Department of Veterans Affairs care by a greater margin than simply returning to pre–Affordable Care Act levels of coverage.
Though an early adopter of the ACA, Oregon has more progress to make toward providing access to affordable health care. Partnering with RAND, the state evaluated three new health care financing options.
When comparing different approaches to tax-based health insurance subsidies, there are unavoidable trade-offs. But any tax-based subsidy that increases health insurance enrollment is likely to increase health systems costs.