Modeling Emerging Health Reform Proposals for 2016 and 2017


Presidential candidates and congressional members from both parties have offered alternatives to the Affordable Care Act, ranging from enhancements to the current law to repeal-and-replace proposals. Under a previous grant, the RAND team modeled the effects of repealing the individual mandate, expanding premium rate bands, replacing the law’s graduated tax credits with flat tax credits, and redesigning the Cadillac tax. Most recently, the researchers evaluated a repeal-and-replace proposal. As plans and policy changes are proposed, it will be important to have the capacity to model their effects on coverage, affordability, and federal spending. Using its proprietary COMPARE microsimulation model, the RAND investigators will analyze the likely impact of policy changes and alternatives under discussion. The model has been used in the past to project the impact of major U.S. policy changes, including the ACA, for studies commissioned by The Commonwealth Fund and the U.S. Departments of Labor and Health and Human Services, among others. Potential proposals or policy components that could be modeled include: a forthcoming proposal developed by a House GOP task force to repeal and replace the ACA; additional protections for people with high prescription drugs costs; expanded use of health savings accounts; allowing insurers to sell across state lines; and modifications to the tax credits available in the ACA marketplaces. Findings from this project will inform policymakers, the media, and the public about the enrollment, premium, out-of-pocket spending, and budgetary effects of changes to the ACA. The analyses will contribute important information to the health policy debate in the 2016 election as well as to the new presidential administration.

Grant Details

Grantee Organization:
RAND Corporation
Principal Investigator:
Christine Eibner, Ph.D.
Award Amount:
Approval Date:
July 13, 2016

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