Subject(s)
Insurance Coverage/economics , Insurance, Health/economics , Medicaid/economics , Patient Protection and Affordable Care Act/trends , Unemployment , Child , Health Benefit Plans, Employee/economics , Health Benefit Plans, Employee/trends , Humans , Insurance Coverage/trends , Insurance, Health/trends , Medicaid/trends , Patient Protection and Affordable Care Act/economics , Unemployment/trends , United States/epidemiologyABSTRACT
The return of a Democratic administration to the White House, coupled with coronavirus disease 2019 (COVID-19) pandemic-induced contractions of job-based insurance, may reignite debate over public coverage expansion and its costs. Decades of research demonstrate that uninsured people and people with copays and deductibles use less care than people with first-dollar coverage. Hence, most economic analyses of Medicare for All proposals and other coverage expansions project increased utilization and associated costs. We review the utilization surges that such analyses have predicted and contrast them with the more modest utilization increments observed after past coverage expansions in the US and other affluent nations. The discrepancy between predicted and observed utilization changes suggests that analysts underestimate the role of supply-side constraints-for example, the finite number of physicians and hospital beds. Our review of the utilization effects of past coverage expansions suggests that a first-dollar universal coverage expansion would increase ambulatory visits by 7-10 percent and hospital use by 0-3 percent. Modest administrative savings could offset the costs of such increases.
Subject(s)
Ambulatory Care/statistics & numerical data , Costs and Cost Analysis/economics , Insurance Coverage/economics , Patient Acceptance of Health Care/statistics & numerical data , Universal Health Care , COVID-19 , Humans , Medicaid/economics , Medically Uninsured , Medicare/economics , Patient Protection and Affordable Care Act/economics , United StatesABSTRACT
The Affordable Care Act played a major role in transitioning American health care away from fee-for-service payment. We explore the spread of payment reforms since the implementation of the ACA, both nationally and in North Carolina; the corresponding effects on health care costs and quality; and further steps needed to achieve greater transformation.
Subject(s)
Health Care Costs/trends , Health Care Reform/economics , Patient Protection and Affordable Care Act/economics , Betacoronavirus , COVID-19 , Coronavirus Infections , Humans , North Carolina , Pandemics , Pneumonia, Viral , SARS-CoV-2 , United StatesSubject(s)
Delivery of Health Care , Politics , Betacoronavirus , COVID-19 , COVID-19 Testing , Clinical Laboratory Techniques , Coronavirus Infections/diagnosis , Coronavirus Infections/epidemiology , Drug Costs , Emigration and Immigration/legislation & jurisprudence , Humans , Leadership , Negotiating , Pandemics , Patient Protection and Affordable Care Act/economics , Patient Protection and Affordable Care Act/legislation & jurisprudence , Pneumonia, Viral/diagnosis , Pneumonia, Viral/epidemiology , Prescription Drugs/economics , Reproductive Health Services/legislation & jurisprudence , SARS-CoV-2 , United States/epidemiologyABSTRACT
The Supreme Court holds that the government owes insurers the full risk corridors payments due under the Affordable Care Act.