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Health Insurance Benefit Design

Journal Article
Donald Trump's Health Care Reform Proposals: Anticipated Effects on Insurance Coverage, Out-of-Pocket Costs, and the Federal Deficit
The Trump health care proposal would decrease the number of insured and increase consumer health spending among those with marketplace insurance relative to current law. The policies would also increase the federal deficit by varying amounts.
Nov 4, 2016
Report
Implementing a Drug Formulary for California's Workers' Compensation Program
This report supports the California Division of Workers' Compensation's efforts to establish a drug formulary by comparing existing workers' compensation formularies and analyzing options for designing and implementing the formulary.
Aug 25, 2016
Journal Article
Prescription Drug Use Rises, Out-of-Pocket Spending Drops Among Those Newly Insured Under the ACA
A study of nearly 7 million prescription drug users' experiences provides strong evidence that the Affordable Care Act has increased treatment rates while reducing out-of-pocket spending, particularly for those with certain chronic health conditions.
Aug 19, 2016
Report
Policy Options for Covering High-Cost Cures
Strategic behavior by health insurers could unravel the market for cures for chronic diseases. The cost of these cures is front-loaded, but the benefits build up over time. Thus, insurers might try to delay treatment or avoid patients who need it, in the hope that they change insurers.
May 3, 2016
Journal Article
Medicare Prescription Plan Enrollees' Experiences Compared to Their Medicare Advantage Counterparts
Medicare enrollees with standalone prescription coverage reported less positive experience with their plans than their counterparts in Medicare Advantage plans.
Mar 14, 2016
Journal Article
Policy Options for Providing ACA Subsidies
The ACA provides tax subsidies to qualified individuals for purchasing insurance while retaining tax exemptions for contributions to employer-sponsored insurance premiums. There are several options for leveling the financial playing field between the two markets.
Dec 10, 2015
Commentary
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
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
Journal Article
Early Marketplace Enrollees Were Older and Used More Medication
Prescription data on more than one million Marketplace patients shows that those who enrolled earlier were older and used more medication than later enrollees. However, Marketplace enrollees as a whole had lower average drug spending than the employer-sponsored comparison group.
May 29, 2015
Content
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
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
Journal Article
Comparing Employer-Sponsored and Federal Exchange Plans: Wide Variations in Cost Sharing for Prescription Drugs
Our primary objective was to examine the variability in drug coverage in the exchanges across plan types (health maintenance organization or preferred provider organization) and metal tiers (bronze, silver, gold, and platinum).
Mar 9, 2015
Journal Article
Impact of Out-of-Pocket Spending Caps on Financial Burden of Those with Group Health Insurance
Mandated uniform out-of-pocket caps for those with group insurance will benefit very few individuals, and will not result in substantial reductions in financial burden.
Mar 9, 2015
Journal Article
A Research Note on Transitions in Out-of-Pocket Spending on Dental Services
The authors analyze correlates of the direction and magnitude of changes in out-of-pocket (OOP) payments for dental care by older Americans over a recent 4-year period.
Feb 26, 2015
Research Brief
How Does Enrollment of Young Invincibles Affect Premiums in the ACA Individual Market?
Using the COMPARE microsimulation model, researchers estimated the effects of reduced enrollment of young adults (invincibles) in the individual health insurance market. Results indicate that reduced enrollment of invincibles is associated with only modest premium increases.
Feb 5, 2015
Research Brief
What If King v. Burwell Had Turned Out Differently?
The Supreme Court has ruled that the Affordable Care Act's subsidies can continue in all states. According to RAND research cited in the court's majority opinion, a different outcome could've resulted in higher premiums and about 8 million uninsured Americans.
Jan 16, 2015
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
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
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
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

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RAND Health Care