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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.

Report
How to Prevent Health Insurance Loss During Future Recessions
The pandemic–related recession and job loss raised concerns that millions of Americans would lose their health insurance. But temporary aid to protect coverage prevented that from happening. Making the enhanced marketplace tax credits in the American Rescue Plan permanent could keep coverage stable in future recessions.
Nov 12, 2021
Commentary
The Importance of Getting the Affordable Part of the Affordable Care Act Right
The ACA's expansion of Medicaid and the marketplaces that sell subsidized policies have helped decrease the uninsured rate. Research on being underinsured shows that affordability at the point of care is central to keeping people healthy. For example, a new study found a significant relationship between having health insurance and better asthma control.
Jun 17, 2022

Explore Affordable Care Act

Journal Article
The Impact of the Affordable Care Act Insurance Expansions on Opioid-Related Emergency Department Visits
We leverage ACA coverage expansions to study the impact of health insurance on opioid-related emergency department visits while accounting for potentially confounding changes in relevant state-level policies.
Oct 27, 2022
Journal Article
Trends in Missing Race and Ethnicity Information After Imputation in HealthCare.gov Marketplace Enrollment Data, 2015–2021
More than 30% of HealthCare.gov enrollees do not report race and ethnicity. We used modified Bayesian Improved First Name Surname geocoding imputations to describe enrollment data and assess patterns of missing enrollee race and ethnicity.
Jun 24, 2022
Journal Article
Section 1332 Waiver Evaluation Report: Evaluating the Oregon Reinsurance Program
This report documents findings from the evaluation of Oregon's waiver, through which the state implemented the Oregon Reinsurance Program (ORP).
Mar 29, 2022
Journal Article
Section 1332 Waiver Evaluation Report: Evaluating the Minnesota Reinsurance Program
This report documents findings from the evaluation of Minnesota's waiver, through which the state implemented the Minnesota Premium Security Plan.
Mar 29, 2022
Journal Article
Section 1332 Waiver Evaluation Report: Evaluating the Alaska Reinsurance Program
This report documents findings from the evaluation of Alaska's waiver, through which the state implemented the Alaska Reinsurance Program (ARP).
Mar 29, 2022
Journal Article
Access to High-Cost Medications After a Cap on Monthly Out-of-Pocket Spending in California
This cross-sectional study evaluates the association of a cap on monthly out-of-pocket spending on high-cost drugs with use of these drugs and out-of-pocket spending in California in 2015 and 2016.
Mar 4, 2022
Commentary
Temporary Safety-Net Policies Prevented Mass Insurance Loss During the Pandemic
Although it provided a foundation, the ACA alone could not have absorbed the effects of the pandemic's sudden job losses on health care coverage. Temporary expansions to the safety net enacted by Congress also were necessary to stem coverage loss. As the pandemic continues, policymakers will want to keep safety-net provisions as available policy options.
Dec 13, 2021
News Release
Boosting Tax Credits and Other Aid Could Prevent Health Insurance Loss During Future Recessions
The federal Affordable Care Act was not robust enough on its own to stave off a large number of people in New York from losing their health coverage during the pandemic-related recession.
Nov 15, 2021
Blog
Boosting Vaccine Acceptance, Afghanistan's Refugee Crisis, Environmental Racism: RAND Weekly Recap
This weekly recap focuses on addressing vaccine hesitancy, preventing an even-bigger humanitarian crisis in Afghanistan, and how to develop antiracist environmental policies.
Sep 10, 2021
News Release
Republicans May Be Less Likely to Make Use of Federal Subsidies When Buying Individual Health Insurance Policies
Republicans who buy individual health plans may be less likely to shop through marketplaces created under the federal Affordable Care Act, leading them to forgo subsidies provided by the federal government.
Sep 8, 2021
Commentary
How Insurance Marketplace Regulators Can Help Consumers Enroll in Better Coverage
The Affordable Care Act simplified shopping for health care by creating the individual health insurance marketplaces where plans are categorized into labeled tiers. Consumers rely on these labels when comparing plans. But the labels don't tell consumers everything they need to know.
Aug 2, 2021
Commentary
ACA Subsidies for Higher-Income Families Are Key to Enrolling More Americans
The House Ways and Means Committee has proposed several insurance reforms in its emergency COVID-19 relief package, including increasing subsidizes and extending subsidies to people with higher incomes. The proposed combined approach is a far more efficient means of covering uninsured Americans than enhancing subsidies only for those who are currently eligible.
Mar 1, 2021
Dissertation
Exploring the Influences of External Factors on the Veteran Disability Compensation Program
Explores factors affecting the performance and scope of the veteran disability compensation program.
Feb 23, 2021
Journal Article
Low Rates of Pediatric Dental Coverage for Families Purchasing Marketplace Insurance Plans
Pediatric dental care is an essential health benefit that the Affordable Care Act requires most private health plans to cover. It is unknown how these different pediatric dental coverage offerings may affect uptake of coverage.
Feb 12, 2021
Journal Article
Changes in Pediatric Dental Coverage and Visits Following the Implementation of the Affordable Care Act
Comparing pre- and post-ACA periods, private dental insurance increased by 4.6% (P=0.013) and annual dental visits were unchanged (2.7%, P=0.071) comparing children likely or unlikely to be affected by the ACA.
Feb 2, 2021
Content
U.S. Health Care Policy
The U.S. health care policy landscape is poised for great change. 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 rating regulations, and essential health benefits.
Dec 1, 2020
Journal Article
The Affordable Care Act, Breastfeeding, and Breast Pump Health Insurance Coverage
Viewpoint on the Affordable Care Act, breastfeeding, and breast pump health insurance coverage.
Nov 17, 2020
Blog
'Internet of Bodies,' COVID-19 as a Preexisting Condition, Preventive Health Care: RAND Weekly Recap
This weekly recap focuses on the potential risks and benefits of the 'Internet of Bodies,' what might happen if the ACA is struck down and COVID-19 is considered a preexisting condition, a drop in the use of preventive care, and more.
Nov 6, 2020

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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