Because of the ACA's regulations, some smaller employers with young and healthy workers are considering avoiding the purchase of health care coverage in the regulated market, opting instead to self-insure their employees.
Self-insurance rates will increase among small firms only under the hypothetical situation that generous stop-loss policies are available to them after implementation of the ACA. Even if many small firms choose to self insure under this situation, it will not increase the premiums charged in the insurance exchanges by more than a few tenths of a percent.
In this December 2012 Congressional Briefing, Amelia Haviland presents the results of several RAND studies on cost and quality in consumer-directed health plans, including how a switch to such plans may affect the quality of health care for participating families.
Researchers explore how hospital pay for performance would affect health system performance with respect to spending, patient experience, health, waste, consumer financial risk, coverage, and capacity.