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Affordable Care Act

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Through a number of provisions — such as individual and employer mandates, health insurance exchanges, and the expansion of Medicaid — the Patient Protection and Affordable Care Act (ACA) aims to expand access to health care for uninsured Americans. RAND has examined implementation challenges, cost and coverage implications, Medicaid expansion, state health insurance exchanges, and reforms to both care delivery and payment.

Content

The Affordable Care Act: An Overview of the Evidence

Apr 8, 2015

RAND researchers have analyzed the Patient Protection and Affordable Care Act—the sweeping health care reform sometimes known as “Obamacare”—from many different angles. Here's what they've learned.
Commentary

What If the Supreme Court Strikes Down the ACA During the Pandemic?

Apr 3, 2020

With COVID-19 spreading across the United States, the fate of the Affordable Care Act is once again up in the air, hanging on the outcome of a Supreme Court case. Should the law be overturned, upwards of 20 million people could lose their health insurance during one of the deadliest pandemics in modern history.

Explore Affordable Care Act

Commentary

Options for Designing a Public Option

State and federal policymakers are considering adding state-backed public options to the individual market in an effort to expand health coverage and improve affordability. We analyzed what would happen if public options became available in U.S. health insurance exchanges.

May 28, 2020
News Release

News Release

Public Option Could Lower Health Insurance Premiums, But Would Not Substantially Raise Number of Insured

Offering a government-sponsored health plan with publicly determined payment rates to people who buy their own insurance could lower the cost of premiums, but on its own it is unlikely to substantially increase the overall number of people with coverage.

May 28, 2020
Report

Report

Public Options for Individual Health Insurance: Assessing the Effects of Four Public Option Alternatives

There is growing interest in a "public option" for individual market insurance to improve affordability and enrollment. The authors estimate how adding a federal public option could affect enrollment, premiums, and government spending.

May 27, 2020
Research Brief

How Would a Public Option on Health Insurance Affect Costs and Coverage?

Interest in a government-sponsored health insurance plan with publicly determined provider rates is growing. An analysis of four such public option plans finds that lower provider payment rates would lower premiums. But the effect on enrollees also depends on tax credits. And changes to the number of uninsured would be small.

May 27, 2020
Blog

Hospitals' Critical Care Capacity, Unemployment Insurance, Farmworkers: RAND Weekly Recap

This weekly recap focuses on how hospitals can increase critical care capacity, reforming the U.S. unemployment system, supporting farmworkers, and more.

Apr 10, 2020
Blog

COVID-19 and the Economy, America's Blood Supply, 10 Years of the ACA: RAND Weekly Recap

This weekly recap focuses on COVID-19 and the economy, strengthening the U.S. blood supply, 10 years of the Affordable Care Act, and more.

Mar 27, 2020
Journal Article

Journal Article

Specialty Care Access for Medicaid Enrollees in Expansion States

In a survey of community health center medical directors in 9 Medicaid expansion states and DC, nearly 60% reported difficulty obtaining new specialist visits and multiple access barriers on behalf of their patients.

Nov 27, 2019
News Release

News Release

Opening Medicare to Americans Aged 50 to 64 Would Cut Their Insurance Costs, but Drive Up Insurance Prices for Younger ...

Opening Medicare to Americans aged 50 to 64 would lower health care premiums for the group, but also drive up costs for younger people who buy health insurance on exchanges created under the federal Affordable Care Act.

Nov 18, 2019
Report

Medicare for 50-to-64-Year-Olds

Allowing Americans aged 50 to 64 to buy into Medicare would lower health care premiums for the group. But it would also drive up costs for younger people who buy health insurance on Affordable Care Act exchanges.

Nov 17, 2019
Report

Options for Reinvesting Savings from Restored Federal Cost-Sharing Reduction Payments: Examining the Effects of Two Policy Alternatives on Spending and Enrollment in the Individual Health Insurance Market

The authors of this report examine the impact of providing additional health insurance subsidies or financing reinsurance from the savings resulting from restored federal cost-sharing reduction payments to insurers under the Affordable Care Act.

Sep 10, 2019
Report

Effects of Alternative Insurer Responses to Discontinued Federal Cost-Sharing Reduction Payments: Broad Loading as an Alternative to Silver Loading

In this report, the authors assess the effects of disallowing the current practice of increasing only the premiums of silver-tiered individual market plans in response to discontinued federal payments of cost-sharing reductions (silver loading).

Jun 3, 2019
Journal Article

Expanding Enrollment Without the Individual Mandate: Options to Bring More People Into the Individual Market

The options analyzed would increase individual market enrollment by 400,000 to 3.2 million in 2020. Net increases in total enrollment (300,000 to 2.4 million) are smaller because of offsetting decreases in employer-sponsored insurance.

Dec 27, 2018
Commentary

All Health Policy Is Local: The Case of the Individual Mandate Penalty in New York

As with many Affordable Care Act policies, how New York is dealing with the absence of the individual mandate penalty is a potent reminder that all health policy is local.

Oct 30, 2018
News Release

News Release

Complex and Rapidly Changing Payment Models Challenge Physician Practices

Physician payment models are becoming more complex and the pace of change is increasing, creating challenges for physician practices that might hamper their ability to improve the quality and efficiency of care despite their willingness to change.

Oct 24, 2018
Research Brief

The Effects of Alternative Payment Models on Physician Practices: Follow-Up Study

Physician practice engagement with alternative payment models (APMs) would be enhanced by simpler APMs, a slower pace of change, greater support for new capabilities and timely data, and reexamination of practice response to APMs with financial risk.

Oct 24, 2018
Report

Physicians Struggle to Keep Up with Changing Payment Models

Alternative payment models cause administrative burdens that take doctors away from patient care. Slowing the rate of change and simplifying payment models could help them focus on patients. And getting physicians' input on the design of new payment methods might improve their engagement.

Oct 24, 2018
Journal Article

Keeping Young Adults Insured Means More Mental Health Care

Lack of insurance has been a barrier to mental health treatment for young adults. The ACA's Dependent Care Expansion, which allows them to stay on their parents' policies until age 26, has increased use of mental health care among this high need group—without affecting quality of care or disparities in access.

Sep 21, 2018
Report

Impacts of Eliminating the Individual Mandate Penalty in New York

In 2019, the ACA's individual mandate penalty will be eliminated. How will this affect New York's nongroup insurance market? It could result in an estimated 23 to 25 percent increase in premiums and a 37 percent reduction in enrollment.

Sep 20, 2018
Journal Article

Journal Article

Extending Marketplace Tax Credits Would Make Coverage More Affordable for Middle-Income Adults

Middle-income adults ages 50-64 would have more affordable coverage if the ACA's tax credits were extended to all income groups; this would improve the individual market risk pool because premiums for this group would exceed the cost of their care.

Aug 24, 2018

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RAND Topic:
Affordable Care Act

Topic Synonyms:
ACA;
Health Care Bill;
Health Care Reform Bill;
Healthcare Bill;
Healthcare Reform Bill;
HR 3200;
Patient Protection and Affordable Care Act

Research conducted by

RAND Health Care