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

    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.

    Nov 18, 2019

  • A health insurance application on a tablet, photo by grinvalds/Getty Images

    Research Brief

    How Would a Public Option on Health Insurance Affect Costs and Coverage?

    Interest in a government-sponsored health insurance plan with publicly determined provider rates is growing. An analysis of four such public option plans finds that lower provider payment rates would lower premiums. But the effect on enrollees also depends on tax credits. And changes to the number of uninsured would be small.

    May 28, 2020

Explore Health Insurance

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    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


    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


    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

  • Healthy food on an office desk


    Five Steps to a Successful Workplace Wellness Program

    Workplace wellness programs can reduce health risks, lower health care costs, and improve productivity — but all programs are not created equal. This toolkit presents a five-step guide for the planning, implementation, and evaluation of a successful workplace wellness program.

    Jun 24, 2014

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    A Bitter Pill: Soaring Health Care Spending and the American Family

    Health care costs nearly doubled between 1999 and 2009, which left the average 2009 family with only $95 more per month than in 1999. If costs had matched the consumer price index's rise, the average family would have an additional $450 per month.

    May 23, 2014

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    Research Brief

    Effects of Employer Health Insurance on Disability Insurance Claiming

    Health insurance and employment decisions often go hand in hand in the U.S. because most health insurance is provided by employers. The Affordable Care Act (ACA) will change the way some workers think about their health care because they will now be able to find coverage through insurance exchanges regardless of health or employment status.

    May 22, 2014

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    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

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    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

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    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

  • a doctor discussing a patient's chart on a tablet


    RAND Health Reform Opinion Study: Few Changes After Open Enrollment

    At the close of the ACA's open enrollment period, no significant changes in opinion were observed in the RAND Health Reform Opinion Study. This may be because open enrollment has no bearing on the health insurance of many people.

    Apr 16, 2014

  • News Release

    News Release

    Affordable Care Act Could Change Costs for Auto, Malpractice, Other Liability Insurance

    As more Americans become newly covered under the ACA, the cost of providing automobile insurance, workers compensation, and homeowners insurance may decline. But an increase in the number of people using the health care system may trigger an increase in the number of medical malpractice claims.

    Apr 9, 2014

  • Research Brief

    Research Brief

    The Impact of the Affordable Care Act on Liability Insurance

    Summarizes a report that identifies potential mechanisms through which health care reform might affect claim costs for several major types of liability coverage, especially auto insurance, workers’ compensation coverage, and medical malpractice.

    Apr 9, 2014

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    ACA Could Change Costs of Auto, Malpractice, and Other Liability Insurance

    As more Americans become newly covered under the Affordable Care Act, the cost of providing automobile insurance, workers compensation, and homeowners insurance may decline. Meanwhile, an increase in the number of people using the health care system may trigger a corresponding increase in the number of medical malpractice claims.

    Apr 9, 2014

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    Survey Estimates Net Gain of 9.3 Million American Adults with Health Insurance

    Early survey evidence indicates that the Affordable Care Act has already led to a substantial increase in insurance coverage. Consistent with the ACA's design, this gain in insurance has come not only from new enrollment in the marketplaces, but also from new enrollment in employer coverage and Medicaid.

    Apr 8, 2014

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    Changes in Health Insurance Enrollment Since ACA Implementation

    Early evidence from a nationally representative survey suggests that the Affordable Care Act has led to a substantial increase in health coverage. Among the newly insured, most gained coverage through employer-sponsored insurance or Medicaid.

    Apr 8, 2014

  • Report


    Final Report: Evaluation of Tools and Metrics to Support Employer Selection of Health Plans

    This report attempts to help employers understand the structural differences between health plans and the performance dimensions along which plans can differ, as well as to educate employers about available tools to evaluate plan options.

    Apr 3, 2014

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    RAND Health Reform Opinion Study: Attitudes Shift as the ACA's Open Enrollment Draws to a Close

    A brighter spotlight on the Affordable Care Act due to its impending open enrollment deadline on March 31 may be further polarizing an already divided populace.

    Mar 27, 2014

  • group of people holding signs of question marks


    Many Americans Are Confused About the Affordable Care Act

    In a nationally representative sample of more than 6,000 Americans, researchers found an acute lack of understanding among low-income people regarding finances in general, and health reform and health insurance in particular.

    Mar 25, 2014

  • Research Brief

    Research Brief

    A Health Care Puzzler

    An American Life Panel survey finds that a lack of knowledge about health reform and health insurance is especially acute among the poor, less educated, young, and females. This presents challenges for implementation of the Affordable Care Act.

    Mar 24, 2014