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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.

Report

Policy Options for Covering High-Cost Cures

May 3, 2016

Strategic behavior by health insurers could unravel the market for cures for chronic diseases. The cost of these cures is front-loaded, but the benefits build up over time. Thus, insurers might try to delay treatment or avoid patients who need it, in the hope that they change insurers.
Journal Article

Prescription Drug Use Rises, Out-of-Pocket Spending Drops Among Those Newly Insured Under the ACA

Aug 17, 2016

A study of nearly 7 million prescription drug users' experiences provides strong evidence that the Affordable Care Act has increased treatment rates while reducing out-of-pocket spending, particularly for those with certain chronic health conditions.

Explore Health Insurance

News Release

News Release

Oregon Has Options to Move Toward Universal Health Coverage; Repeal of the Affordable Care Act Would Make All Options ...

Oregon has options for reforming health care financing to expand coverage and meet broader goals, though they differ in their feasibility, tradeoffs and financing requirements.

Jan 19, 2017
Report

Oregon's Options for Financing Health Care

Federal health care reform had just begun in 2013 when Oregon authorized a study to improve how the state pays for health care. A comparison of the projected impacts and feasibility of four options can help Oregon's stakeholders choose the option that best suits their needs.

Jan 19, 2017
Research Brief

Oregon's Options to Overhaul Health Care Financing: Health Care Reform 2.0?

This analysis of three options to reform health care payment in Oregon (two state-based plans that would ensure coverage for all state residents and a state-sponsored plan offered in Oregon's nongroup market) found benefits and trade-offs for each.

Jan 19, 2017
Report

Modeling Dr. Dynasaur 2.0 Coverage and Finance Proposals: Effects of the Expansion of Vermont's Dr. Dynasaur Program to All Individuals Through Age 25

The authors assessed an expansion of Vermont's Dr. Dynasaur program that would cover all residents through age 25. The current program provides health coverage for children ages 0-18 with family incomes below 317 percent of the federal poverty level.

Jan 18, 2017
Multimedia

The RAND Health Insurance Experiment: A Retrospective at 40 Years

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.

Jan 12, 2017
Commentary

Repeal-and-Delay Would Make Budget Neutrality for ACA Replacement Difficult

As Congress considers repealing and replacing the Affordable Care Act it will need to consider how federal budget scoring can affect the fate of legislation. Depending on the ultimate cost of a replacement, finding enough savings to offset costs while maintaining budget neutrality could make it difficult to pass a replacement.

Jan 11, 2017
Commentary

Improving MACRA's Chances of Success

Starting in 2019, the Medicare Access and CHIP Reauthorization Act will integrate and potentially simplify performance measurement by combining a number of measures and programs. Research on performance measurement provides a good deal of insight on how to avoid several pitfalls in MACRA's rollout.

Jan 9, 2017
Commentary

Can a Continuous Coverage Requirement Produce a Healthy Insurance Market?

A continuous coverage requirement aims to discourage individuals from waiting until they become sick to buy insurance. This works well in theory. But there is little evidence on how it might work in practice.

Jan 4, 2017
Journal Article

Journal Article

The National Adult Immunization Plan: Strengthening Adult Immunization Through Coordinated Action

Addressing persistent structural and policy barriers to adult immunization will benefit all Americans.

Jan 3, 2017
Report

Effects of the ACA's Medicaid Expansion on Health Insurance Enrollment

Insurance coverage increases were larger for newly eligible adults in states that expanded Medicaid, but take-up was lower among men, Hispanics, and adults under 36.

Dec 29, 2016
Commentary

Insuring Younger Adults Through the ACA's Marketplaces: Options to Expand Enrollment

Whether or not the Affordable Care Act is repealed, having young adults participate in the individual health insurance market remains critical to achieving affordable premiums for everyone.

Dec 16, 2016
Journal Article

Knowledge About Health Insurance and Finance Linked to Higher Rates of Health Coverage

Uninsured individuals who knew more about health insurance and finance were more likely to gain coverage under the ACA. Policies and programs aiming to reduce the numbers of uninsured should consider the financial literacy and health insurance knowledge of the groups they are trying to reach.

Dec 12, 2016
Journal Article

Lactation Support Services and Breastfeeding Initiation: Evidence from the Affordable Care Act

The likelihood that mothers with private health insurance would start breastfeeding increased by 2.5 percentage points after the Affordable Care Act mandated the coverage of lactation support services.

Nov 28, 2016
Research Brief

Research Brief

How Does Expanding Health Insurance Coverage Affect Workers' Compensation Costs?

The Affordable Care Act's expansion of coverage for people under age 26 led to a 1-percent reduction in uninsurance, equating to a 0.8-percent decrease in workers' compensation claim frequency, and a roughly 1-percent decrease in overall claim costs.

Nov 22, 2016
News Release

News Release

Knowledge About Health Insurance and Finance Linked to Higher Rates of Health Coverage

Policies and programs aiming to reduce the numbers of uninsured should take into account the financial literacy and health insurance knowledge of the groups they are trying to reach.

Nov 17, 2016
Journal Article

Journal Article

Donald Trump's Health Care Reform Proposals: Anticipated Effects on Insurance Coverage, Out-of-Pocket Costs, and the Federal Deficit

The Trump health care proposal would decrease the number of insured and increase consumer health spending among those with marketplace insurance relative to current law. The policies would also increase the federal deficit by varying amounts.

Nov 4, 2016
Journal Article

Journal Article

Hillary Clinton's Health Care Reform Proposals: Anticipated Effects on Insurance Coverage, Out-of-Pocket Costs, and the Federal Deficit

The Clinton health care proposal would increase the number of insured individuals and decrease consumers' health spending relative to current law. However, the policies with the largest coverage gains also increase the federal deficit the most.

Nov 4, 2016
Journal Article

Journal Article

Can a More User-Friendly Medicare Plan Finder Improve Consumers' Selection of Medicare Plans?

Enhancements to the Medicare Plan Finder website not only improved user experience but also helped users make good decisions when choosing plans.

Nov 3, 2016
Commentary

Easing the Pain When Critical Medications Are No Longer Covered

Allowing insurance companies to limit the drugs they cover is necessary to give them leverage that can result in lower medication costs for all patients. Still, there are ways to make the process more transparent and manageable.

Oct 28, 2016
Journal Article

Journal Article

HIV Tests and New Diagnoses Declined After California Budget Cuts, but Reallocating Funds Helped Reduce Impact

When California's 2009 budget crunch eliminated supplemental funding for HIV prevention, state and local programs redirected remaining funds from risk reduction education to testing, thus somewhat dampening reductions in testing.

Oct 13, 2016

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RAND Topic:
Health Insurance

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