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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.

Journal Article

The Effect of Eliminating the ACA's Individual Mandate

Jul 12, 2018

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.
Report

Effects of the ACA's Medicaid Expansion on Health Insurance Enrollment

Dec 29, 2016

Increases in insurance coverage were larger in states that expanded Medicaid, but take-up was lower among men, Hispanics, and adults under 36.

Explore Affordable Care Act

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
Journal Article

Evaluating the CARE Act: Implications of a Proposal to Repeal and Replace the Affordable Care Act

Policymakers seeking to adopt the CARE Act, or to pursue a similar repeal-and-replace policy, may need to maintain some of the ACA's revenue-generating provisions, adopt alternative revenue-generating provisions, or reduce the generosity of tax credits to achieve budget neutrality.

Aug 22, 2018
Commentary

Understanding the Impact of the Elimination of the Individual Mandate Penalty

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.

Aug 10, 2018
Journal Article

Journal Article

What Is the Impact on Enrollment and Premiums If the Duration of Short-Term Health Insurance Plans Is Increased?

Extending the duration of short-term individual health plans will have little effect on premiums or enrollment in the individual market.

Jun 14, 2018
Journal Article

Journal Article

Medicare Advantage Penetration and Hospital Costs Before and After the Affordable Care Act

Prior to the ACA, Medicare Advantage (MA) enrollment growth led to small reductions in inpatient for the entire population over age 65. After the ACA, this impact diminished, contrary to the hypothesis that the MA ACA payment would amplify this effect.

Apr 12, 2018
Journal Article

Journal Article

Early Impact of the Affordable Care Act Coverage Expansion on Safety-Net Hospital Inpatient Payer Mix and Market Shares

Following Medicaid expansion, non safety-net hospitals experienced a greater percentage increase in Medicaid stays than did safety-net hospitals, which may reflect patient choice or a crowd-out of private insurance.

Feb 14, 2018
Journal Article

Effect of the Affordable Care Act on Breastfeeding Outcomes

When new mothers have affordable access to lactation support services and breast pumps, they are more likely to breastfeed until their infants are ready to transition to solid foods.

Feb 9, 2018
Commentary

Tax Reform Could Raise Car Insurance Rates

The new tax law eliminates the individual mandate. When this repeal takes effect in 2019, millions more Americans are expected to go without health insurance. Auto insurers will likely pick up the tab for some of that population's medical care. That could raise car insurance premiums.

Feb 4, 2018
Journal Article

Options to Expand Health Insurance Enrollment in the Individual Market

Policymakers have many options to expand coverage in the individual market. We considered federal investments that would enhance, extend, or increase the tax credits available to enrollees, as well as reinsurance approaches that would lower premiums.

Oct 31, 2017
Blog

Beyond the Headlines: RAND's Christine Eibner Discusses Health Care Reform

The issue of how to improve health care in the United States is complicated. At a RAND event, senior economist and Paul O'Neill Alcoa Chair in Policy Analysis Christine Eibner discussed modifications to the Affordable Care Act and the long-term outlook for health care reform.

Oct 27, 2017
Report

The Effects of Iowa's Proposed Stopgap Measure on Health Insurance Costs and Coverage

This report uses RAND's COMPARE microsimulation model to estimate the effects of a 1332 waiver application from the state of Iowa. The waiver is designed to stabilize Iowa's Affordable Care Act individual market through a series of modifications.

Oct 17, 2017
Commentary

Why ACA Enrollees Need Support After They Sign Up

Providing support for Affordable Care Act enrollees to connect with care they are happy with can help minimize the risk that they will stop seeking routine health care.

Oct 11, 2017
Report

Report

The Impact of Health Reform on Purchased Care Access: National Health Reform and Modernization of the Military Health System Study

Newly insured patients through the Affordable Care Act coverage expansion may change how civilian providers interact with the TRICARE program. Some physicians may face financial incentives to drop TRICARE patients for newly insured patients.

Sep 27, 2017
Commentary

Do Americans Expect Too Much from Health Insurance?

Americans expect affordable coverage for pre-existing conditions, access to routine services, and protection from unpredictable and significant financial risk from accidents or illness. As a product designed primarily for risk protection, insurance may not be the most efficient or affordable approach to achieving all of these objectives.

Sep 23, 2017
News Release

News Release

Repealing or Replacing Affordable Care Act Would Result in More Uninsured Veterans, Increase Stress on VA Health System

Proposals to repeal or replace the federal Affordable Care Act would likely increase the demand for service in the Veterans Affairs medical system, while also increasing the number of veterans who have no insurance coverage at all.

Sep 14, 2017
Research Brief

How Might Veterans and the VA Health System Be Affected by Repeal of the ACA?

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.

Sep 14, 2017
Report

Repealing or Replacing ACA Would Result in More Uninsured Veterans and Stress on VA Health System

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.

Sep 14, 2017

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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