CORPORATION
Research Report
The Effects of the American
Health Care Act on Health
Insurance Coverage and Federal
Spending in 2020 and 2026
Christine Eibner, Jodi L. Liu, Sarah A. Nowak
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iii
Preface
In this report, we analyzed a version of the American Health Care Act (AHCA), a bill
proposed by the U.S. House of Representatives on March 6, 2017. The bill would have repealed
many of the provisions of the Affordable Care Act (ACA) and replaced them with alternative
reforms. We used RAND’s Comprehensive Assessment of Reform Efforts microsimulation
model to assess how the AHCA would have affected such outcomes as health insurance
enrollment, consumer out-of-pocket costs, and the federal deficit relative to the ACA. The report
may be of interest to policymakers, researchers, and journalists considering how proposals like
the AHCA might influence health care coverage and federal spending.
Funding for this study was provided by the Commonwealth Fund. Additional support was
made possible by the generous contributions of the RAND Health Board of Advisors and other
donors.
We thank Katherine Carman, Leighton Ku, and Evan Saltzman for their helpful reviews of
this document.
The research was conducted in RAND Health, a division of the RAND Corporation. A
profile of RAND Health, abstracts of its publications, and ordering information can be found at
rand/health.
iv
Contents
Preface ....... iii
Figures and Tables ... v
Abbreviations ......... vi
Overview ..... 1
Results ......... 6
Comparison with CBO Estimates ........... 12
Conclusion ........... 17
Methods Appendix: COMPARE Overview .......... 18
Approach to Modeling the Affordable Care Act . 19
Approach to Modeling the American Health Care Act ... 23
Sensitivity to Assumptions About the Individual Market ........... 29
References . 32
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