Eibner Christine, Price Carter C
Rand Health Q. 2012 Mar 1;2(1):2. eCollection 2012 Spring.
This article describes the results of an analysis using RAND's COMPARE (rehensive ssessment of eform fforts) microsimulation model to predict the effects of a possible Supreme Court decision invalidating the individual mandate provision in the Patient Protection and Affordable Care Act of 2010 while keeping the other parts of the law intact. The authors predict the effects of such a decision on health insurance coverage overall and for subgroups based on income. They also estimate where people will obtain insurance in scenarios with and without the mandate and how the elimination of the individual mandate will affect insurance premiums. The analysis predicted that, if the individual mandate were to be eliminated: (1) 12.5 million people who would have otherwise signed up for coverage will be uninsured. (2) Premium prices in the non-group market will increase by 2.4 percent. (3) Total government spending will increase modestly, from $394 billion to $404 billion in 2016. (4) The amount of government spending will more than double, from $3,659 to $7,468. The study estimates a smaller effect on premiums than comparable studies because the RAND team uses a method that accounts for the difference in the age composition of enrollees with and without the mandate.
本文描述了一项分析结果，该分析使用兰德公司的COMPARE（医保改革全面评估）微观模拟模型，来预测美国最高法院一项可能的裁决所产生的影响。这项裁决会判定2010年《患者保护与平价医疗法案》中的个人强制参保条款无效，同时保持该法律的其他部分不变。作者预测了这样一项裁决对总体医疗保险覆盖情况以及不同收入亚组的影响。他们还估计了在有和没有强制参保条款的情况下，人们将从何处获得保险，以及取消个人强制参保条款将如何影响保险费。该分析预测，如果取消个人强制参保条款：（1）原本会参保的1250万人将无保险可保。（2）非团体市场的保险费价格将上涨2.4%。（3）政府总支出将适度增加，从2016年的3940亿美元增至4040亿美元。（4）政府支出金额将增加一倍多，从3659美元增至7468美元。该研究估计，与同类研究相比，对保险费的影响较小，因为兰德团队使用的一种方法考虑了有和没有强制参保条款情况下参保者年龄构成的差异。
