Report
Veterans' Health Insurance Coverage Under the Affordable Care Act and Implications of Repeal for the Department of Veterans Affairs
Sep 14, 2017
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As congressional debate over its future continues, the Affordable Care Act's (ACA's) effects on U.S. military veterans and the impact of the ACA's possible repeal on the Department of Veterans Affairs (VA) health system have received little attention. A new study by the RAND Corporation seeks to give policymakers and the public a better understanding of connections among the ACA, veterans' insurance coverage, and demand for care from the VA health system. The RAND research team addressed two major topics to analyze the potential impact of an ACA repeal on veterans and the VA system. The study documents how health insurance coverage for nonelderly veterans (those under age 65) has changed since the ACA's major coverage provisions took effect in 2014. The study also analyzes how ACA repeal could lead to unintended consequences for the VA health care system if veterans with significant health care needs were to lose access to health coverage they had newly gained under the ACA. Estimates are provided at both the national and state levels.
The study's key findings include the following:
The RAND research team also estimated how changes in veterans' insurance coverage anticipated under the House-passed American Health Care Act of 2017 (AHCA) might affect demand for VA health services. The following findings reflect the coverage impacts anticipated under the AHCA in 2026, when changes to the Marketplaces would be fully phased in and the conversion of federal Medicaid funding to a capped allocation would have been in effect for six years. The full report provides more-detailed estimates, including analysis of the AHCA's impacts as of 2020.
SOURCES: Authors' calculations, 2008–2014 Medical Expenditure Panel Survey, 2015 Integrated Public Use Microdata Series American Community Survey, and VA's VetPop2016 demographic model. See the full report for details.
Key findings about ACA repeal include the following:
Although passage of the AHCA as analyzed in this study currently appears unlikely, legislative proposals that result in similar coverage changes across groups of veterans would likely have a similar impact on VA demand. The results of the RAND team's analysis may help policymakers concerned about veterans' health and the ability of the VA system to meet patient demands to more accurately anticipate the effects of ACA repeal.
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