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):10. 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 Connecticut, 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 Connecticut will fall to 5 percent; without the law, it would remain at 11 percent. The model projects that total state government spending on health care will be 10 percent lower for the combined 2011-2020 period than it would be without the ACA, mostly because of federal subsidies for residents who would have been covered by Connecticut's state-run health insurance program (State-Administered General Assistance).
《患者保护与平价医疗法案》（ACA）包含旨在提高医疗保险覆盖率的大量新要求。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。对于康涅狄格州，该模型预测，在2016年（ACA中所有与覆盖范围扩大相关的条款将全面实施的年份），康涅狄格州的未参保率将降至5%；若无该法案，这一比例将维持在11%。该模型预计，在2011 - 2020年的合并期间，州政府在医疗保健方面的总支出将比没有ACA时低10%，这主要是因为联邦政府为原本将由康涅狄格州的州立医疗保险计划（州管理的一般援助）覆盖的居民提供了补贴。
