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The Impacts Of The Affordable Care Act: How Reasonable Are The Projections?

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  • Gruber, Jonathan
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    Abstract

    The Patient Protection and Affordable Care Act (ACA) is the most comprehensive reform of the U.S. medical system in at least 45 years. The ACA transforms the non-group insurance market in the United States, mandates that most residents have health insurance, significantly expands public insurance and subsidizes private insurance coverage, raises revenues from a variety of new taxes, and reduces and reorganizes spending under the nation’s largest health insurance plan, Medicare. Projecting the impacts of such fundamental reform to the health care system is fraught with difficulty. But such projections were required for the legislative process, and were delivered by the Congressional Budget Office (CBO). This paper discusses the projected impact of the ACA in more detail, and describes evidence that sheds light upon the accuracy of the projections. It begins by reviewing in broad detail the structure of the ACA, and then reviews evidence from a key case study that informs our understanding of the ACA’s impacts: a comparable health reform that was carried out in Massachusetts four years earlier. The paper discusses the key results from that earlier reform and what they might imply for the impacts of the ACA. The paper ends with a discussion of the projected impacts of the ACA and offers some observations on those estimates.

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    Bibliographic Info

    Article provided by National Tax Association in its journal National Tax Journal.

    Volume (Year): 64 (2011)
    Issue (Month): 3 (September)
    Pages: 893-908

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    Handle: RePEc:ntj:journl:v:64:y:2011:i:3:p:893-908

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    Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:
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    1. Gruber, Jonathan & Lettau, Michael, 2004. "How elastic is the firm's demand for health insurance?," Journal of Public Economics, Elsevier, Elsevier, vol. 88(7-8), pages 1273-1293, July.
    2. Gruber, Jonathan, 2011. "The Tax Exclusion For Employer-Sponsored Health Insurance," National Tax Journal, National Tax Association, National Tax Association, vol. 64(2), pages 511-30, June.
    3. Jonathan Gruber, 2008. "Covering the Uninsured in the United States," Journal of Economic Literature, American Economic Association, American Economic Association, vol. 46(3), pages 571-606, September.
    4. Jonathan Gruber, 2011. "Massachusetts points the way to successful health care reform," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., John Wiley & Sons, Ltd., vol. 30(1), pages 184-192, December.
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    Cited by:
    1. Silvia Barbaresco & Charles J. Courtemanche & Yanling Qi, 2014. "Impacts of the Affordable Care Act Dependent Coverage Provision on Health-Related Outcomes of Young Adults," NBER Working Papers 20148, National Bureau of Economic Research, Inc.
    2. Randy Albelda & Diana Salas Coronado, 2014. "Expanding Women's Healthcare Access in the United States: The Patchwork “Universalism†of the Affordable Care Act," Working Papers 2014_02, University of Massachusetts Boston, Economics Department.
    3. Richard V. Burkhauser & Sean Lyons & Kosali I. Simon, 2011. "The Importance of the Meaning and Measurement of “Affordable” in the Affordable Care Act," NBER Working Papers 17279, National Bureau of Economic Research, Inc.
    4. Stavrunova, Olena & Yerokhin, Oleg, 2014. "Tax incentives and the demand for private health insurance," Journal of Health Economics, Elsevier, Elsevier, vol. 34(C), pages 121-130.
    5. repec:sip:wpaper:12-028 is not listed on IDEAS

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