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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.
Blog

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

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

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
Commentary

COVID-19: Preexisting Condition in a Post-ACA World?

The Affordable Care Act is far from perfect, but its protections are particularly relevant to the COVID-19 pandemic. If the ACA is struck down, then protections for preexisting conditions will go with it. Policymakers should consider the potential implications for millions of COVID-19 survivors.

Nov 4, 2020
Report

Consolidation by Any Other Name: The Emergence of Clinically Integrated Networks

In this report, the authors offer an initial assessment of clinically integrated networks (CINs), describe how health systems are using CINs strategically to compete in crowded health care markets, and identify why CINs require further study.

Aug 3, 2020
Blog

Preparing for a COVID Surge, Reducing Police Violence, Media Literacy in Schools: RAND Weekly Recap

This weekly recap focuses on helping hospitals prepare for a surge in COVID-19 infections, an approach to reducing police violence, teachers' concerns about students' media literacy, and more.

Jul 2, 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
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
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 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 28, 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 18, 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

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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