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The Affordable Care Act and Health Insurance Markets
In this report, the authors estimate the effects of the Affordable Care Act on health insurance enrollment and premiums for ten states (Florida, Kansas, Louisiana, Minnesota, New Mexico, North Dakota, Ohio, Pennsylvania, South Carolina, and Texas) and for the nation overall, with a focus on outcomes in the nongroup and small group markets.
Evaluating the "Keep Your Health Plan Fix"
This report describes a comparative analysis of three proposals to allow Americans to keep their existing health plans under the Affordable Care Act (ACA). The proposals are evaluated based on their potential impact on the ACA-compliant market and the cost and coverage of health insurance. The possibility of each proposal causing a “death spiral” in the ACA-compliant market is also addressed.
Assessing Alternative Modifications to the Affordable Care Act
This report summarizes analysis in which the COMPARE microsimulation model was used to estimate how several potential changes to the Affordable Care Act, including eliminating the individual mandate and eliminating the law’s tax-credit subsidies, might affect 2015 individual market premiums and overall insurance coverage. The report also presents estimate how changes in young adult enrollment might affect 2015 individual market premiums.
The Economic Burden of Providing Health Insurance
More than 60 percent of nonelderly Americans receive health-insurance (HI) coverage through employers, either as policyholders or as dependents. However, rising health-care costs are leading many to question the long-term viability of the employer-based insurance system. Concerns about the economic burden of providing HI are particularly acute for small businesses, which are both less likely than larger firms to offer HI and more sensitive to price when deciding to offer insurance. Small firms may have difficulty containing costs due to their limited bargaining power and their inability to hir.
How Do ACA Tax Subsidies Affect Premiums and Enrollment?
This brief describes work done in RAND Health documented in Assessing Alternative Modifications to the Affordable Care Act: Impact on Individual Market Premiums and Insurance Coverage, by Christine Eibner and Evan Saltzman, RR-708-DHHS, 2014 (available at www.rand.org/t/RR708), and The Effect of Eliminating the Affordable Care Act's Tax Credits in Federally Facilitated Marketplaces, by Evan Saltzman and Christine Eibner, RR-980-RC, 2015 (available at www.rand.org/t/RR980).
Consumer Decisionmaking in the Health Care Marketplace
"The Patient Protection and Affordable Care Act introduced the health insurance marketplaces, new online clearinghouses for buying and selling insurance. One of the benefits of the marketplaces is that they enable consumers to compare a variety of health insurance plans, and, ideally, select the plan that best suits their needs. However, the task of selecting a health insurance plan can be complicated because of such factors as difficulty understanding health insurance jargon, poor numeracy, inadequate decision-support tools, and an excessive number of choices. For this report, RAND researchers reviewed the literature on health insurance choice to understand how consumers make decisions and ...
Maintaining Military Medical Skills During Peacetime
This monograph examines the feasibility of a new model for maintaining the clinical skills of the military medical force. Under the model, active-duty personnel would be assigned to civilian settings during peacetime. The study on which this monograph is based explored the feasibility of this model from a civilian perspective, focusing on civilian receptiveness to the proposed arrangement and identifying potential barriers and concerns. The study found that civilian medical organizations are generally receptive to the idea of such a model and that DoD could consider conducting a pilot study to assess the effectiveness of the model in improving military medical readiness.
Civilian Workforce Planning in the Department of Defense
In response to more than a decade of downsizing and restructuring, the Department of Defense (DoD) is engaged in a human-resources strategic planning effort to address resulting imbalances in both skills and experience levels in many parts of DoD. The current human-resources strategic plan addresses the need to provide management systems and tools to support total workforce planning and informed decisionmaking (U.S. Department of Defense, 2003b). Attention to Department-wide civilian workforce planning stems in part from the President's Management Agenda of 2001 and the continuing assessments of Department-level progress on workforce planning. DoD civilian workforce-planning efforts are complicated and, at the same time, made more important by the implementation of the National Security Personnel System (NSPS), slated to begin in 2006. The NSPS will replace the traditional federal civil service personnel management system within DoD, providing DoD managers with more management flexibility.
