Auerbach David I, Nowak Sarah A, Ringel Jeanne S, Girosi Federico, Eibner Christine, McGlynn Elizabeth A, Wasserman Jeffrey
Rand Health Q. 2011 Jun 1;1(2):1. eCollection 2011 Summer.
The Patient Protection and Affordable Care Act (ACA) contains substantial new requirements aimed at increasing rates of health insurance coverage. Because many of these provisions impose additional costs on the states, officials need reliable estimates of the likely impact of the ACA in their state. To demonstrate the usefulness of modeling for state-level decisionmaking, RAND undertook a preliminary analysis of the impact of the ACA on five states-California, Connecticut, Illinois, Montana, and Texas-using the RAND COMPARE microsimulation model. For California, the model predicts that, in 2016 (the year that all of the provisions in the ACA related to coverage expansion will be fully implemented), the uninsured rate in California will fall to 4 percent; without the law, it would remain at 20 percent. The model projects that total state government spending on health care will be 7 percent higher for the combined 2011-2020 period because of the ACA.
《患者保护与平价医疗法案》（ACA）包含大量旨在提高医疗保险覆盖率的新要求。由于其中许多条款给各州带来了额外成本，官员们需要对ACA在本州可能产生的影响进行可靠估计。为了证明建模对州级决策的有用性，兰德公司利用兰德比较微观模拟模型，对ACA在加利福尼亚州、康涅狄格州、伊利诺伊州、蒙大拿州和得克萨斯州这五个州的影响进行了初步分析。对于加利福尼亚州，该模型预测，到2016年（ACA中所有与扩大医保覆盖范围相关的条款将全面实施的年份），加利福尼亚州的未参保率将降至4%；若没有该法案，未参保率将维持在20%。该模型预计，由于ACA，2011年至2020年期间州政府的医疗保健总支出将高出7%。
