Price Carter C, Donohue Julie M, Saltzman Evan, Woods Dulani, Eibner Christine
Rand Health Q. 2013 Jun 1;3(2):5. eCollection 2013 Summer.
The Affordable Care Act is a substantial reform of the U.S. health care insurance system. Using the RAND COMPARE model, researchers assessed the act's potential economic effects on Pennsylvania, factoring in an optional expansion of Medicaid, and found the state would enjoy significant net benefits. With or without the expansion of Medicaid, the act will increase insurance coverage to hundreds of thousands of Pennsylvanians, but the COMPARE model estimates that the expansion of Medicaid eligibility would cover an additional 350,000 people and bring more than $2 billion in federal spending into the state annually than if the state did not expand. Should the state expand Medicaid, the additional spending will add more than $3 billion a year to the state's GDP and support 35,000 jobs. But Medicaid expansion is not without cost for the state; the estimated cumulative effect on Pennsylvania's Medicaid spending will be $180 million higher with the expansion than without between 2014 and 2020. Substantial reductions in uncompensated care costs for hospitals are possible even without expansion, but savings to hospitals for uncompensated care funding are even larger with the Medicaid expansion, amounting to $550 million or more each year.
《平价医疗法案》是美国医疗保险体系的一项重大改革。研究人员使用兰德比较模型，评估了该法案对宾夕法尼亚州可能产生的经济影响，并将医疗补助计划的一项可选扩张因素考虑在内，结果发现该州将获得显著的净收益。无论医疗补助计划是否扩张，该法案都将使数十万宾夕法尼亚人获得保险覆盖，但比较模型估计，与该州不扩张相比，医疗补助资格的扩张将额外覆盖35万人，并每年为该州带来超过20亿美元的联邦支出。如果该州扩张医疗补助计划，额外支出将每年为该州的国内生产总值增加超过30亿美元，并支持3.5万个就业岗位。但医疗补助计划的扩张对该州来说并非没有成本；预计在2014年至2020年期间，扩张后的宾夕法尼亚州医疗补助支出累计影响将比不扩张高出1.8亿美元。即使不扩张，医院的未补偿医疗费用也可能大幅降低，但医疗补助计划扩张后，医院在未补偿医疗资金方面的节省甚至更大，每年达5.5亿美元或更多。
