Serakos Maria, Wolfe Barbara
La Follette School of Public Affairs, University of Wisconsin-Madison, Madison, WI, USA.
Forum Health Econ Policy. 2016 Dec;19(2):201-259. doi: 10.1515/fhep-2015-0027. Epub 2016 May 31.
On March 23, 2010, President Barack Obama signed the Patient Protection and Affordable Care Act (ACA) into law. This comprehensive health care reform legislation sought to expand health care coverage to millions of Americans, control health care costs, and improve the overall quality of the health care system. The ACA required that all US citizens and legal residents have qualifying health insurance by 2014. In this paper we give readers a brief overview of the effects of the ACA based on recent research. We then turn our attention to the possibility of using the ACA expansion to answer important underlying questions, such as: To what extent does the holding of insurance lead to improvements in access to care? To what extent does the holding of coverage lead to improvements in health? In mental health? Are there likely general equilibrium effects on labor force participation, hours worked, employment setting, and indeed even the probability of marrying? By necessity, researchers' ability to answer these questions depends on the availability of data, so we discuss current and potential data sources relevant for answering these questions. We also look to what has been studied about the health reform in Massachusetts and early Medicaid expansions to speculate what we can expect to learn about the effects of the ACA on these outcomes in the future.
2010年3月23日，巴拉克·奥巴马总统签署了《患者保护与平价医疗法案》（ACA）使其成为法律。这项全面的医疗保健改革立法旨在将医疗保险覆盖范围扩大到数百万美国人，控制医疗保健成本，并提高医疗保健系统的整体质量。ACA要求所有美国公民和合法居民在2014年前拥有符合条件的医疗保险。在本文中，我们根据最近的研究向读者简要概述ACA的影响。然后，我们将注意力转向利用ACA扩展来回答重要基本问题的可能性，例如：拥有保险在多大程度上能改善医疗服务的可及性？拥有保险覆盖范围在多大程度上能改善健康状况？在心理健康方面呢？对劳动力参与、工作时长、就业环境，甚至结婚概率是否可能存在一般均衡效应？必然地，研究人员回答这些问题的能力取决于数据的可用性，所以我们讨论与回答这些问题相关的当前和潜在数据源。我们还研究了马萨诸塞州的医疗改革以及早期医疗补助扩展方面的研究情况，以推测未来我们有望了解到ACA对这些结果的影响。
