Impact of Affordable Health Care

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NBER WORKING PAPER SERIES THE IMPACTS OF THE AFFORDABLE CARE ACT: HOW REASONABLE ARE THE PROJECTIONS? Jonathan Gruber Working Paper 17168 NATIONAL BUREAU OF ECONOMIC RESEARCH 1050 Massachusetts Avenue Cambridge, MA 02138 June 2011 Forthcoming as part of a Forum on Health Care Reform and the U.S. Budget, National Tax Journal. Jonathan Gruber served as a paid advisor to the Romney Administration and Massachusetts Legislature during the development of health care reform in Massachusetts, and has since been a member of the Commonwealth Health Connector Board that oversees implementation of the law. He was also a paid technical consultant to the Obama Adminstration during the development of the Affordable Care Act. The views expressed herein are those of the author and do not necessarily reflect the views of the National Bureau of Economic Research. © 2011 by Jonathan Gruber. All rights reserved. Short sections of text, not to exceed two paragraphs, may be quoted without explicit permission provided that full credit, including © notice, is given to the source. The Impacts of the Affordable Care Act: How Reasonable Are the Projections? Jonathan Gruber NBER Working Paper No. 17168 June 2011 JEL No. H3,I18 ABSTRACT The Patient Protection and Affordable Care Act (ACA) is the most comprehensive reform of the U.S. medical system in at least 45 years. The ACA transforms the non-group insurance market in the United States, mandates that most residents have health insurance, significantly expands public insurance and subsidizes private insurance coverage, raises revenues from a variety of new taxes, and reduces and reorganizes spending under the nation’s largest health insurance plan, Medicare. Projecting the impacts of such fundamental reform to the health care system is fraught with difficulty. But such projections were required for

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