Ten years after the passing of the Affordable Care Act—the most comprehensive health care reform of the past half-century—most of the previously uninsured continue to lack coverage. Policymakers and members of the public have expressed growing support for expanding the role of public financing of health care. The “public option” and “Medicare for All” have emerged as important contenders for health policy reform. Both policies are rooted in widening access to the lower prices of the public system to make health care more affordable for all.
For any expansion of publicly financed care to improve equity in medical services, we must be expanding an adequate system of care delivery. Yet, the literature remains largely unclear about the value of medical care provided by private versus public coverage, and about the drivers of insurance demand for the publicly- and uninsured.
More specifically, can Medicaid deliver the same level of care as the gold standard employment-based system?
In this project, the research team will use a novel simulation technique to explore whether private insurance provides more medical care than public coverage, asking:
- Is there a difference across types of insurance coverage in the quantity of health care consumed (e.g., number of provider visits, prescriptions, diagnostic services)
- Is there a difference across types of insurance coverage in the mix of health care consumed (e.g., the percentage of visits taken in primary- versus specialty care; in an office or clinic versus in a hospital; and the percent receiving a prescription versus alternative therapies?)
The answers to these questions are vital to help prioritize policy efforts to both expand existing publicly financed health care and improving the system to best serve those who need it.