Featured Research

Eliminating the Individual Mandate: Effects on Premiums, Coverage, and Uncompensated Care
Matthew Buettgens and Caitlin Carroll

The federal requirement for most Americans to have health insurance-the individual mandate-is an important part of how the ACA would reduce the number of uninsured. We use the Health Insurance Policy Simulation Model to estimate the effects of health reform with and without the mandate. With the mandate, the number of uninsured would decrease from 50 million to 26 million. Without a mandate, about 40 million would remain uninsured. Depending on the effectiveness of the health benefit exchanges in enrolling those eligible for subsidized coverage, exchange premiums would be 10 to 25 percent higher without a mandate. Read more 

The Potential Savings from Enhanced  Chronic Care Management Policies
John Holahan, Cathy Schoen, and Stacey McMorrow

The United States spent an estimated $635 billion on the chronically ill and disabled in 2010; about half of this was spent on those dually eligible for Medicare and Medicaid. Recently, there has been a series of innovative chronic care management programs that have shown considerable promise in reducing hospital admissions, readmissions, specialty care and prescription drug use. Considerable savings could be achieved if these programs could be expanded broadly. In this paper, we argue that this should primarily be a Medicare initiative because most of the current expenditures and savings from these programs would accrue to Medicare. We estimate potential savings of close to 1% of national health expenditures. Read more

Why Employers Will Continue to Provide Health Insurance: The Impact of the Affordable Care Act

Linda Blumberg, Matthew Buettgens, Judy Feder and John Holahan

The Congressional Budget Office, the Rand Corporation, and the Urban Institute have estimated that the Affordable Care Act (ACA) will leave employer-sponsored coverage largely intact; in contrast, some economists and benefit consultants argue that the ACA encourages employers to drop coverage thereby making both their workers and their firms better off (a “win–win” situation).

This brief’s analysis shows that no such “win–win” situation exists and that employer-sponsored insurance will remain most workers’ primary source of coverage. Analysis of three issues—the terms of the ACA, worker characteristics, and the fundamental economics of competitive markets—supports this conclusion. The key to the ACA’s impact on employer-sponsored insurance will be whether most employers continue to believe that their employees prefer access to workplace-based coverage, and this analysis suggests that they will. Read more