Health Insurance


The U.S. health insurance model frequently costs more and provides less care than systems in other Western nations. RAND's health insurance research began in 1971 with the 15-year Health Insurance Experiment, the only community-based experimental study of how cost-sharing arrangements affect people’s use of health services, their quality of care, and their health status. Subsequent research has continued to inform the U.S. policy debate.

  • A patient sitting on an MRI machine talking to a medical professional, photo by laflor/Getty Images


    Medicare for 50-to-64-Year-Olds

    Nov 17, 2019

    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.

  • Multimedia

    The RAND Health Insurance Experiment: A Retrospective at 40 Years

    Jan 12, 2017

    In June 2016, RAND hosted a two-day celebration to mark the 40th anniversary of the RAND Health Insurance Experiment (HIE), the largest, most comprehensive, evidence-based health policy study in U.S. history.

Explore Health Insurance

  • Journal Article

    The Oregon Experiment—effects of Medicaid on Clinical Outcomes

    Despite the imminent expansion of Medicaid coverage for low-income adults, the effects of expanding coverage are unclear. The 2008 Medicaid expansion in Oregon based on lottery drawings from a waiting list provided an opportunity to evaluate these effects.

    May 1, 2013

  • "My Medicaid Matters" rally on Capitol Hill


    Governors Missing the Point on Medicaid

    While a governor or legislator may disagree with Medicaid expansion for philosophical reasons, the claims that the expansion will be a burden on states' economies seem misguided given the full range of projected economic impacts on the states, writes Carter C. Price.

    Apr 29, 2013

  • a health insurance claim form and a silver pen


    Helping Obama—and Other Americans—Weigh Which Health Insurance Exchange to Pick

    Multistate plans are most likely to appeal to out-of-state students, interstate migrants, out-of-state workers, seasonal movers (e.g., “snowbirds”), and similar groups that require improved access to health care across state lines.

    Apr 1, 2013

  • Migrant workers load cucumbers into a truck in Blackwater, Virginia

    Journal Article

    Retirement and Health Benefits for Mexican Migrant Workers Returning from the United States

    Mexican migrants who have spent at least a year in the United States before returning home are less likely to have public health insurance or social security benefits, and could be more vulnerable to poverty in old age.

    Apr 1, 2013

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    Multistate Health Plans in the ACA's State Insurance Exchanges

    The ACA requires the government to work with insurance issuers to establish at least two multistate plans (MSPs) in each state's health insurance exchange. MSPs may be especially attractive to those interested in issuers that operate in multiple states, such as out-of-state students or temporary workers.

    Mar 20, 2013

  • man discussing treatment with a doctor


    Are You a 'Wise' Health Care Consumer?

    To be wise purchasers of health care services, consumers need access to accurate and understandable information about health plans and providers. They wrongly assume that more expensive providers are better than less expensive ones, despite inconsistent evidence that there is any link between health care cost and quality.

    Feb 5, 2013

  • A girl and her mother with a doctor


    In Brief: Amelia M. Haviland on Consumer-Directed Health Plans

    In this video, Amelia Haviland presents the results of several new RAND studies on cost and quality in consumer-directed health plans, and explores how switching plans affects the quality of care.

    Jan 23, 2013

  • couple discussing their finances


    Health Care Cost Growth Is Hurting Middle-Class Families

    Unfortunately, nearly every actor in our health care delivery system—hospitals, physicians, other health care providers, insurance companies, and the manufacturers of drugs and devices—is currently focused on maximizing revenue growth, write Arthur Kellermann and David Auerbach.

    Jan 8, 2013

  • dollar sign and a stethoscope


    Health Care Costs Are Killing Us

    At a time when our country is teetering on the edge of a “fiscal cliff,” no challenge in health care is more important than reducing health care spending, writes Arthur L. Kellermann.

    Jan 4, 2013

  • Arkansas flag


    The Economic Impact of the ACA on Arkansas

    For Arkansas, the Affordable Care Act will result in an increase in GDP of around $550 million and the creation of about 6,200 jobs. The new law will also increase health insurance coverage by 400,000 newly insured individuals.

    Jan 3, 2013

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    Journal Article

    Medicare Payment Reform and Provider Entry and Exit

    An investigation of the impacts of Medicare payment reform on post-acute providers found that payment reforms reducing average and marginal payments reduced entries and increased exits from the market, which may affect market structure, access to care, quality and cost of care, and patient outcomes.

    Jan 1, 2013

  • Journal Article

    The Role of Specialty Drugs in Private Sector Healthcare Spending

    Specialty drugs account for a modest share of total healthcare spending, even among the highest cost patients. Even dramatic reductions in spending on specialty drugs would have only a modest effect on total healthcare costs.

    Jan 1, 2013

  • Journal Article

    Implications of New Insurance Coverage for Access to Care, Cost-Sharing, and Reimbursement

    Many physician practices will face a set of critical decisions in the coming years that may contribute to the ultimate success or failure of the ACA.

    Jan 1, 2013

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    Journal Article

    Price Shopping in Consumer-Directed Health Plans

    Based on insurance claims for nine common outpatient services in consumer-directed health plans (CDHPs), researchers found no evidence that those with lower expected medical expenses engaged in more price shopping. Consumers did not engage in more price shopping before reaching the CDHP deductible, either.

    Jan 1, 2013

  • Journal Article

    Access to Leave Benefits for Primary Caregivers of Children with Special Health Care Needs: A Double Bind

    We examined whether access to benefits varies by level of childcare responsibilities among employed parents of children with special health care needs (CSHCN).

    Jan 1, 2013

  • Journal Article

    Modeling Employer Self-Insurance Decisions After the Affordable Care Act

    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.

    Jan 1, 2013

  • Journal Article

    The COMPARE Microsimulation Model and the U.S. Affordable Care Act

    In anticipation of upcoming health care legislation, the RAND Corporation developed a microsimulation model to forecast the responses of individuals, families and firms to such legislation.

    Jan 1, 2013

  • a doctor holding a clipboard talking to a patient


    Creating More Savvy Consumers Through Public Reporting

    Consumer Assessment of Healthcare Providers and Systems (CAHPS) surveys are designed to capture patients' experiences in a systematic way that facilitates reporting the results publicly to help other consumers make more savvy care decisions. Consumer choices may influence providers to improve the care they offer so that they can effectively compete in the market.

    Dec 27, 2012

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    Skin in the Game: How Consumer-Directed Health Plans Can Affect the Cost and Use of Health Care

    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.

    Dec 10, 2012

  • health insurance form

    Research Brief

    Engage and Empower Consumers to Contain Health Care Spending

    Cost-sharing leads consumers to reduce both highly beneficial and less beneficial care, so they must be empowered with useful information to make informed decisions. Public cost and quality reports must be accurate, accessible, and understandable.

    Nov 15, 2012