Health Care Reform


The debate within the U.S. government about reforming the health care system centers on ways to control rising costs and assure high-quality, affordable care. RAND Health Care provides objective research and analysis on topics that can inform the health care reform debate, including financing; increasing access, insurance coverage, and quality; decreasing costs; and promoting wellness and prevention.

  • Person standing in a field looking toward mountains in the distance. Photo by Ivana Cajina/Unsplash

    Research Brief

    How to Transform Mental Health Care in the United States

    With scientific advances, Medicaid expansion, and political consensus on the importance of improving mental health, the time is ripe for transforming the U.S. mental health system. This will mean structural reforms that address patients' challenges in finding, accessing, and receiving high-quality and timely care.

    Jan 11, 2021

  • Health insurance form with model of COVID-19 virus and pen, photo by ajaykampani/Getty Images


    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

Explore Health Care Reform

  • Woman's finger on a calculator with laptop and mouse in the background


    Can the Cadillac Tax Be Made Less Regressive by Replacing It with an Exclusion Cap? Methods and Results

    Examines the effects of the Affordable Care Act's Cadillac tax versus an alternative tax, based on an exclusion gap, on families in different income ranges.

    Oct 8, 2015

  • A senior man receives a consultation from his doctor


    Charging Older Adults Higher Premiums Could Cost Taxpayers

    Under the Affordable Care Act, older adults cannot be charged more than three times as much as 21- to 24-year-olds for the same plan. Changing this rule to 5-to-1 may not be a cost-effective way to encourage enrollment among the young and healthy.

    Sep 15, 2015

  • Periodical


    RAND Review: September-October 2015

    This issue of RAND Review reports on the staggering costs of dementia in the United States; the most critical global choices and challenges the next U.S. president will likely face; tips to protect the health of kids heading back to school; and more.

    Aug 21, 2015

  • Calculator and stethoscope on a spreadsheet


    The Ramifications of Repealing the Individual Mandate

    As part of its goal of near-universal coverage, the Affordable Care Act requires most Americans to obtain insurance or pay a penalty. Repealing that requirement would significantly reduce health insurance enrollment and cause individual market premiums to rise.

    Aug 13, 2015

  • Supporters of the Affordable Care Act celebrate after the Supreme Court ruled in favor of the Obama administration, Washington, DC, June 25, 2015


    Why Obamacare Lives

    Economic reasoning took center stage in the Supreme Court's decision on Thursday to uphold the legality of the Affordable Care Act's subsidies in all states. The subsidies are critical to ensuring that healthy people, with lower health care costs, have adequate incentive to enroll.

    Jun 26, 2015

  • Demonstrators hold signs showing the number of people they say could lose affordable health care in King v. Burwell, in front of the Supreme Court building, March 4, 2015


    What Americans Know About King v. Burwell

    An upcoming Supreme Court ruling regarding the Affordable Care Act could impact millions of Americans. Are Americans aware of the court case? And if so, what do they know about it?

    Jun 12, 2015

  • Research Brief

    Research Brief

    How Does the ACA Individual Mandate Affect Enrollment and Premiums in the Individual Insurance Market?

    Describes how removing the Affordable Care Act's individual mandate would affect health insurance premiums and the overall numbered of insured.

    Jun 4, 2015

  • News Release

    News Release

    Health Coverage Grows Under Affordable Care Act

    Insurance coverage has increased across all types of insurance since the major provisions of the federal Affordable Care Act took effect, with a net total of 16.9 million people becoming newly enrolled through February 2015.

    May 6, 2015

  • Report


    Insurance Transitions Following the First ACA Open Enrollment Period

    This report examines health insurance transitions between September 2013 and November 2014 using longitudinal data from the RAND Health Reform Opinion Study.

    May 6, 2015

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    Methodology of the RAND Health Reform Opinion Study

    This report describes a methodology to track transitions in health insurance enrollment between November 2014 and December 2015.

    May 6, 2015

  • Brochure


    RAND's Impact in the Middle East

    Provides an overview of RAND's impact in the Middle East in the areas of supporting youth, health and health care, education, energy and environment, labor market reform and private-sector development, capacity-building, and planning for the future.

    Apr 29, 2015

  • Medical personnel gathered around a laptop

    Journal Article

    Using Research to Transform the Health Care System

    Using the knowledge base developed by health services research can stimulate innovative thinking about how to make health care systems safer, more efficient, more cost effective, and more patient centered.

    Apr 22, 2015

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


    The Affordable Care Act: An Overview of the Evidence

    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.

    Apr 8, 2015

  • Doctors reviewing an MRI

    Journal Article

    Medically Unnecessary Diagnostic Imaging: Emergency Physicians Weigh In

    A substantial proportion of advanced imaging studies ordered by emergency physicians may be medically unnecessary. According to a broad survey of emergency medicine professionals, fear of missing a low-probability diagnosis and fear of litigation are perceived as two key contributing factors.

    Apr 7, 2015

  • Doctor consulting with patient

    Journal Article

    Emergency Physician Perceptions of Shared Decision-Making

    A substantial proportion of advanced imaging studies ordered by emergency physicians may be medically unnecessary.

    Apr 7, 2015

  • American flag, stethoscope, and money

    Research Brief

    How Would Alternative Subsidy Structures Affect Stability in the ACA Individual Market?

    Subsidies in the ACA's health insurance exchanges help stabilize the insurance market by encouraging younger, healthier people to stay enrolled in the face of premium hikes. Critics of the current subsidies have proposed alternatives. What effects would these have?

    Apr 6, 2015

  • U.S. President Barack Obama speaks alongside Americans he says will benefit from the Affordable Care Act's marketplaces, October 1, 2013


    Five Years of the Affordable Care Act

    The Affordable Care Act has officially been part of the U.S. health care landscape for five years. We reflect on the twists and turns that followed its passage and the RAND research that informed debates along the way, and look ahead to the future of the ACA.

    Mar 23, 2015

  • News Release

    News Release

    Details and Context of New Payment Models Are Critical to Efforts of Physician Practices to Improve Care

    Physician practices are engaging in new health care payment models intended to improve quality and reduce costs, but are finding that they need help with managing increasing amounts of data and figuring out how to respond to the diversity of programs and quality metrics from different payers.

    Mar 19, 2015

  • Doctor writing at his desk next to keyboard and stethoscope


    Physicians Need Support and Guidance to Further Advance Delivery Reforms

    Physicians are engaging in new health care payment models intended to improve quality and reduce costs. They are finding that they need help with managing increasing amounts of data and figuring out how to respond to the diversity of programs and quality metrics from different payers.

    Mar 19, 2015

  • Two doctors looking at a tablet


    Population Health Management and the Second Golden Age of Arab Medicine

    The rapid economic growth of many Gulf Arab states has come with an increase of lifestyle-related diseases. This presents new challenges for health care systems, but Western models offer cautionary lessons that may help.

    Feb 16, 2015

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