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.

  • Barack Obama signing the Patient Protection and Affordable Care Act at the White House, March 23, 2010

    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.

  • The U.S. Supreme Court building in Washington, D.C., January 19, 2020, photo by Will Dunham/Reuters

    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

  • Susan Dentzer, Leonard Schaeffer, Sue Siegel, David Goldhill, and Bob Kocher at RAND's Politics Aside 2014

    Blog

    Innovations in Health Care: New Treatments, Changing Systems

    From the Affordable Care Act and new advances in medical technology to the impact of the aging population, panelists at RAND's Politics Aside discussed a wide-range of topics affecting America's health care system today and into the future.

    Nov 18, 2014

  • Doctor with a clipboard and patients in a waiting room

    Commentary

    The ACA's Tax Credits Keep Premiums Low for Everyone

    The ACA's tax credits currently contain several properties that stabilize premiums while providing assistance to low- and moderate-income people. As policymakers contemplate modifications to the ACA that would affect the tax credits, it will be important to consider not only how they affect those who are eligible, but also how they affect premiums for everyone else.

    Nov 10, 2014

  • Doctor and patient shaking hands

    Commentary

    A Case for Exchange-Based, Long-Term Health Insurance Policies

    Multi-year health plans have the potential to finally align the interests of health plan enrollees and insurers by reaping long-term benefits of patient health management.

    Nov 10, 2014

  • News Release

    Eliminating Subsidies for People to Buy Health Coverage Would Increase Premiums and Number of Uninsured

    Eliminating subsidies that help low- and moderate-income people purchase coverage through government-run health insurance marketplaces would sharply boost costs for consumers as much as 43 percent and cause more than 11 million Americans to lose their health insurance.

    Oct 21, 2014

  • Close up of young woman using laptop

    Research Brief

    Young Adult Enrollment and the Affordable Care Act

    Reduced young-adult enrollment in the individual health insurance market created under the Affordable Care Act would lead to modest premium increases; however, eliminating tax credits would substantially increase premiums and reduce enrollment.

    Oct 21, 2014

  • Mother and son at a medical reception desk

    Report

    Eliminating Subsidies for People to Buy Health Coverage Would Increase Premiums and Number of Uninsured

    Eliminating subsidies that help low- and moderate-income people purchase coverage through government-run health insurance marketplaces would boost costs for consumers as much as 43 percent and cause more than 11 million Americans to lose their health insurance.

    Oct 21, 2014

  • A man looks over the ACA signup page on HealthCare.gov, October 2, 2013

    Commentary

    Happy Birthday, Healthcare.Gov

    This month marks the one-year anniversary of the health insurance Marketplaces—the online exchanges for buying and selling insurance created by the Affordable Care Act. Last year, after a near-disastrous start that included massive website failures, the Marketplaces rebounded to a surprising success.

    Oct 16, 2014

  • Hospital sign in front of hospital building

    Report

    Barriers to Enrollment in Health Coverage in Colorado

    Explores why eligible individuals are not enrolled in health insurance coverage in Colorado and makes recommendations on how Colorado can strengthen its future outreach and enrollment efforts.

    Oct 6, 2014

  • News Release

    Federal Drug Discount Program Faces Challenges as It Expands Under Health Reform

    A federal program that provides billions in drug discounts to safety net hospitals and other health care providers is expanding under health care reform, but divergent views on the purpose and future scope of the program create uncertainty for safety net providers and drug manufacturers.

    Aug 12, 2014

  • U.S. Capitol building with summer flowers

    Blog

    Summer Reading for Congress

    No matter how policymakers spend their break—meeting with home-state constituents, traveling abroad with congressional delegations, or spending time with family—this summer reading list contains policy ideas that can help them hit the ground running when they return.

    Jul 31, 2014

  • A pregnant woman in an exam room with a gynecologist and nurse

    Commentary

    RAND Helps to Develop From Coverage to Care, a New CMS Initiative

    Health coverage is a means to an end: the aim is to help more Americans use their coverage to access routine primary care and preventive services. For many of the newly insured, however, the leap between obtaining insurance and establishing a regular source of care is substantial.

    Jul 29, 2014

  • Doctor talking to her male patient in her office

    Commentary

    The ACA's Opportunity to Improve Care for Substance Use Disorders

    The Affordable Care Act (ACA) will significantly increase coverage for the publicly funded treatment of substance use disorders. But in order to maximize the benefit to patients, families, and society, it's critical to invest in the development, validation, and use of performance measures.

    Jul 28, 2014

  • A prescription bottle labeled Affordable Care Act and prescription pad

    Report

    Federal Drug Discount Program Faces Challenges as It Expands Under Health Reform

    A federal program that provides billions in drug discounts to safety net hospitals and other health care providers is expanding under health care reform, but divergent views on the purpose and future scope of the program create uncertainty for safety net providers and drug manufacturers.

    Jul 21, 2014

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    Research Brief

    Will Heath Care Reform Affect Disability Insurance Claiming?

    By enabling access to affordable private health insurance and expanding access to subsidized public health insurance, the Affordable Care Act alters the calculus of disability claiming decisions. Research offers empirical evidence that, on net, disability applications are likely to decrease.

    Jul 10, 2014

  • Events @ RAND Audio Podcast

    Multimedia

    The Affordable Care Act: Change Is the Only Constant

    Listen as Leonard D. Schaeffer, founding chairman and CEO of WellPoint and RAND’s 2014 Williams Laureate, discusses the effects of the Affordable Care Act.

    Jun 12, 2014

  • Journal Article

    Disproportionate-share Hospital Payment Reductions May Threaten the Financial Stability of Safety-Net Hospitals

    We examined the impact of the ACA's Medicaid DSH reductions on California public hospitals' financial stability by estimating how total DSH costs (uncompensated care costs and Medicaid shortfalls) will change as a result of insurance expansion and the offsetting DSH reductions.

    Jun 1, 2014

  • Pennsylvania capitol building

    Infographic

    Infographic: How Pennsylvania May Fare Under the ACA

    This infographic presents findings from a RAND analysis of the economic and other effects of Medicaid expansion on the commonwealth of Pennsylvania.

    May 21, 2014

  • Arkansas state quarter

    Infographic

    Infographic: How Arkansas May Fare Under the Affordable Care Act

    This infographic presents findings from a RAND analysis of the economic and other effects of the Affordable Care Act on the state of Arkansas.

    May 21, 2014

  • Social secruity card

    Journal Article

    Disability Insurance and Health Insurance Reform: Evidence from Massachusetts

    We study the 2006 Massachusetts health insurance reform to estimate the potential effects of the ACA on SSDI and SSI applications.

    May 1, 2014

  • measuring blood pressure

    Commentary

    Tracking the ACA with the RAND Health Reform Opinion Study

    The HROS uses panel data to track changes in public opinion regarding the Affordable Care Act and insurance coverage. By surveying the same respondents each month, the HROS observes not only aggregate changes, but also individual changes in opinion or insurance coverage over time.

    Apr 22, 2014

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