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Health Insurance Mandates

Commentary
Your Health Insurance May Not Be As Good As Your State Requires—and It's Perfectly Legal
Massachusetts has a law to ensure ease of access to birth control pills, saying there should be no copays and women can fill a 12-month prescription at once. Infertility care has similar protections. But many health plans don't have to comply with state laws because they are “self-insured.”
Jun 9, 2023
Report
Evaluating New York's Medicaid Section 1115 Waiver
New York State’s Medicaid Section 1115 Waiver seeks to enroll a majority of Medicaid beneficiaries into managed care, increase access and service quality, and expand coverage to more low-income New Yorkers. RAND researchers examined whether two components of the 1115 Demonstration Waiver have helped achieve the program’s goals.
Dec 2, 2021
Journal Article
The Complex Cancer Care Coverage Environment: What Is the Role of Legislation? A Case Study from Massachusetts
We identified five current cancer coverage state laws and interviewed experts on their perceptions of the relevance of the laws and how well they meet the current needs of cancer care given rapid changes in therapies.
Oct 13, 2020
Report
Impacts of Eliminating the Individual Mandate Penalty in New York
In 2019, the ACA's individual mandate penalty will be eliminated. How will this affect New York's nongroup insurance market? It could result in an estimated 23 to 25 percent increase in premiums and a 37 percent reduction in enrollment.
Sep 20, 2018
Commentary
Understanding the Impact of the Elimination of the Individual Mandate Penalty
Starting in 2019, the Affordable Care Act's individual mandate penalty will be eliminated, effectively ending the law's requirement that most people have health insurance. While declines in coverage and increases in premiums are likely, the magnitudes of these effects are highly uncertain.
Aug 10, 2018
Journal Article
What Is the Impact on Enrollment and Premiums If the Duration of Short-Term Health Insurance Plans Is Increased?
Extending the duration of short-term individual health plans will have little effect on premiums or enrollment in the individual market.
Jun 14, 2018
Commentary
Four Steps That Could Stabilize the Health Insurance Market
Congress will soon discuss options to stabilize the individual market and ensure that all Americans have access to affordable coverage. Policymakers could encourage enrollment, make targeted investments to lower premiums, fund cost-sharing reductions, and enforce the individual mandate.
Aug 25, 2017
Multimedia
Drama over Health Care Continues
In this Call with the Experts, RAND senior economist Christine Eibner discusses the Affordable Care Act, what policymakers should consider, and changes that the current administration could make.
Apr 11, 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 hard to pass a replacement.
Jan 11, 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
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
Commentary
Modifying the ACA's Family Subsidy Rules to Help Ensure Affordability
The ACA encourages workers to retain employer coverage by restricting their eligibility for marketplace subsidies. Modifying the policy could help 700,000 people gain coverage and lower spending for 1.6 million who are insured but face high health care costs.
Jan 12, 2016
Report
Harnessing Private-Sector Innovation to Improve Health Insurance Exchanges
In this paper, analysts consider privately facilitated health insurance exchanges to address some challenges and deepen the impact of health care reform. In this model, the private sector assumes responsibility for peripheral exchange functions.
Nov 6, 2015
Report
Alternatives to the ACA's Affordability Firewall
This report examines policy impacts of the Affordable Care Act's "affordability firewall," which limits subsidies to individuals lacking access to alternative sources of coverage that are "affordable," and investigates two potential modifications.
Oct 5, 2015
Commentary
The Ramifications of Repealing the Individual Mandate
As part of its goal of near-universal coverage, the Affordable Care Act requires most Americans to obtain insurance or pay a penalty. Repealing that requirement would significantly reduce health insurance enrollment and cause individual market premiums to rise.
Aug 13, 2015
Research Brief
How Does the ACA Individual Mandate Affect Enrollment and Premiums in the Individual Insurance Market?
Describes how removing the Affordable Care Act's individual mandate would affect health insurance premiums and the overall numbered of insured.
Jun 4, 2015
Journal Article
Mandated Coverage of Preventive Care and Reduction in Disparities: Evidence from Colorectal Cancer Screening
Universal insurance coverage may not substantially reduce disparities if systematic differences in plan benefits and cost sharing persist.
May 6, 2015
Blog
Five Years of the Affordable Care Act
The Affordable Care Act has officially been part of the U.S. health care landscape for five years. We reflect on the twists and turns that followed its passage and the RAND research that informed debates along the way, and look ahead to the future of the ACA.
Mar 23, 2015
Research Brief
How Does Enrollment of Young Invincibles Affect Premiums in the ACA Individual Market?
Using the COMPARE microsimulation model, researchers estimated the effects of reduced enrollment of young adults (invincibles) in the individual health insurance market. Results indicate that reduced enrollment of invincibles is associated with only modest premium increases.
Feb 5, 2015
Research Brief
What If King v. Burwell Had Turned Out Differently?
The Supreme Court has ruled that the Affordable Care Act's subsidies can continue in all states. According to RAND research cited in the court's majority opinion, a different outcome could've resulted in higher premiums and about 8 million uninsured Americans.
Jan 16, 2015

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