You have JavaScript turned off! Javascript is required for the best experience on this site.

All Papers: Health Care:

Framing Paper Jun 23, 2021

The Social Insurance System in the U.S.: Policies to Protect Workers and Families

In a new framing paper, Mitchell Barnes, Lauren Bauer, Wendy Edelberg, Sara Estep, Robert Greenstein, and Moriah Macklin examine the U.S. social insurance system. They consider the social insurance system as a whole as well as its component parts, providing an overview of major federal programs in the areas of education and workforce development, health, income support, nutrition, and housing opportunity.

Policy Proposal Mar 10, 2020

A Proposal to Cap Provider Prices and Price Growth in the Commercial Health-Care Market

The United States spends a larger share of its GDP on health care than any other advanced economy. This high private sector health-care spending in the United States is driven mostly by higher prices, with little evidence to suggest that high prices reflect better quality of care. In this proposal, Michael Chernew, Leemore Dafny, and Maximilian Pany discuss how price regulations could be used to constrain commercial provider prices in an efficient manner.

Policy Books May 16, 2019

Recession Ready: Fiscal Policies to Stabilize the American Economy

Slowdowns in the economy are inevitable. While it may be tempting to rely on Federal Reserve policy as a lone response to recessions, this would be a mistake; we know that fiscal stimulus is effective. Rather than wait for a crisis to strike before designing discretionary fiscal policy, we would be better served by preparing in advance. Enacting evidence-based automatic stabilizer proposals before the next recession will help the next recovery start faster, make job creation stronger, and restore confidence to businesses and households.

Economic Facts Jun 13, 2018

The State of Competition and Dynamism:
Facts about Concentration, Start-Ups, and Related Policies

Over the past few decades there have been troubling indications that dynamism and competition in the U.S. economy have declined. Markets are more concentrated than they were a few decades ago, and entrepreneurship is less common, with both the number and employment share of new firms well below the levels of previous decades. Carefully assessing these trends as they relate to public policy is necessary to achieving a more competitive, productive economy that generates broadly shared growth.

Policy Proposal Jun 13, 2018

Improving Efficiency in the Health-Care System:
Removing Anticompetitive Barriers for
Advanced Practice Registered Nurses and Physician Assistants

High levels of U.S. health-care spending and inadequate health outcomes make it vital for policymakers to explore opportunities for enhancing productivity in the health-care sector. However, the potential for these gains is sharply limited by anticompetitive policy barriers in the form of restrictive scope of practice laws imposed on physician assistants and advanced practice registered nurses. Adams and Markowitz examine evidence on the impacts of these restrictions, concluding that states should move to fully authorized scope of practice for these practitioners. The authors explore state and federal policies that could help facilitate this shift.

Framing Paper Jun 29, 2016

The Changing Landscape of American Life Expectancy

During the past 100 years, life expectancy at birth has increased by about 25 years in the United States. However, certain groups—notably older whites and low-income Americans—find their mortality rates either stagnating or rising in recent years. In a new framing paper, The Hamilton Project examines the widening gap in life expectancy and explores policy reforms aimed at extending life expectancy gains for more Americans.

Policy Proposal Oct 7, 2015

Getting the Most from Marketplaces: Smart Policies on Health Insurance Choice

Substantial evidence shows that consumers often lack the high-quality information to select the best insurance plan, and once they have selected a plan they are less likely to switch, even as better plans become available. In response, Ben Handel and Jonathan Kolstad propose that exchanges develop a personalized decision support tool to give consumers the information they need to select the best plan. Additionally, they propose that exchanges establish a system of smart defaults, where an algorithm is used to move consumers to new plans if those plans deliver more value. 

Policy Proposal Oct 7, 2015

A Floor-and-Trade Proposal to Improve the Delivery of Charity-Care Services by Nonprofit Hospitals

Substantial evidence shows that consumers often lack the high-quality information to select the best insurance plan, and once they have selected a plan they are less likely to switch, even as better plans become available. In response, David Dranove, Craig Garthwaite and Christopher Ody propose that exchanges develop a personalized decision support tool to give consumers the information they need to select the best plan. Additionally, they propose that exchanges establish a system of smart defaults, where an algorithm is used to move consumers to new plans if those plans deliver more value. 

Economic Facts Oct 6, 2015

Six Economic Facts about Health Care and Health Insurance Markets after the Affordable Care Act

It is still too soon to completely know the effects of the Affordable Care Act on the health-care system. But looking beyond these considerations, it appears that many enduring economic challenges persist in the markets. In particular challenges like accessing care, delivering high-quality care without waste, and managing new technology. The Hamilton Project offers six economic facts that highlight continuing challenges and complexities in health care and health insurance markets on which the policy debate should focus.

Policy Proposal Oct 5, 2015

Correcting Signals for Innovation in Health Care

When Americans select health insurance, they cannot choose what technologies and treatments to include in their coverage. The fact that Americans have little choice but to buy widely-inclusive coverage sends a distorted signal to medical technology developers—that society is willing to pay practically any price for treatments that offer only incremental health benefits over existing technology. Nicholas Bagley, Amitabh Chandra and Austin Frakt propose three reforms to make health insurance, and ultimately medical innovation, reflect what consumers value.

Policy Proposal Jun 23, 2015

Strengthening Risk Protection through Private Long-Term Care Insurance

Americans currently spend over $300 billion a year on long-term services and supports (LTSS), paid for through government programs, private insurance, and importantly, individuals’ own out-of-pocket spending. Wesley Yin proposes changes to the financing of long-term care (LTC) insurance so that individuals can have more-affordable and more-complete insurance against long-term services and supports (LTSS) expenses, and so insurance firms can manage their risks more efficiently.

Policy Proposal Jun 16, 2014

Reducing Unintended Pregnancies for Low-Income Women

In this policy memo, Isabel Sawhill and Joanna Venator propose that the U.S. Department of Health and Human Services’ Office of Population Affairs, in conjunction with state governments, reduce unintended pregnancies through a social marketing campaign to encourage more young women to use long-acting reversible contraceptives (LARCs). This proposal, targeted at unmarried women between the ages of 15 and 30, aims to expand awareness so more low-income women use a LARC or other method of contraception, thereby reducing the number of unintended pregnancies and lowering the number of children born into poverty. This proposal is chapter three of The Hamilton Project’s Policies to Address Poverty in America, and a segment in Promoting Early Childhood Development.

Economic Analysis Nov 22, 2013

Hunger and the Important Role of SNAP as an American Safety Net

In this economic analysis, The Hamilton Project focuses on two critical issues related to SNAP: (1) the widespread existence of both food insecurity and obesity among low-income children in the United States, and (2) the role of SNAP in fighting poverty during times of weak labor markets. SNAP participation rises and falls in lockstep with the unemployment rate, highlighting SNAP’s role as a safety-net program that bolsters family resources when employment and wages are low.

Policy Proposal Feb 25, 2013

Restructuring Cost Sharing and Supplemental Insurance for Medicare

Cost sharing under the Medicare Parts A & B programs is both variable and uncapped, with an overall structure that is hard to rationalize. Jonathan Gruber proposes reforms to Medicare cost sharing that insures consumers against high out-of-pocket costs, aligns the costs faced by consumers with the actual cost of care, and discourages incentives in private plans that encourage excess use of Medicare benefits.