Two Studies from RAND and Urban Institute Recognized for Impact on Health Policymaking

For Immediate Release:
February 1, 2016
Lindsey Horan

WASHINGTON, D.C. (February 1, 2016) – AcademyHealth today awarded two bodies of work with its prestigious HSR (Health Services Research) Impact Award, which recognizes compelling research that has had a significant impact on health policy and/or practice.

This year's winners are being recognized for having informed the high-profile King v. Burwell Supreme Court case, which was considering the legality of tax credit subsidies in the 34 states with federally-facilitated marketplaces. The recognized research includes:

RAND's COMPARE Microsimulation Model

Using RAND's COMPARE microsimulation model, which helps policymakers understand the likely effects of enacting major health policy reforms by using economic theory to fill in gaps where we have little evidence on consumer response, Dr. Eibner and her team examined the likely effects of possible changes to the Affordable Care Act (ACA). This analysis informed the economic reasoning underpinning the Supreme Court's decision in the King v. Burwell case. In drawing conclusions about whether Congress intended tax credits to be available in states with federally-run exchanges, Chief Justice John Roberts, writing for the majority, cited Dr. Eibner's results showing the sharp increase in premiums in the absence of subsidies, observing that eliminating subsidies "could well push a State's individual insurance market into a death spiral;" "it is implausible," he continued, "that Congress meant for the Act to operate in this manner" (King Et Al. v. Burwell, Secretary of Health Human Services, E Al., No. 14–114).

Urban Institute Briefs: Potential Effects of a Supreme Court Finding for the Plaintiffs in King v. Burwell

While the King v. Burwell case ultimately rested on a complex legal analysis, a set of four Urban Institute briefs, led by Linda Blumberg, contributed immediately and directly to the Court's work by illustrating the multi-dimensional picture of the consequences that could occur from eliminating premium tax credits and cost-sharing reductions. The analyses provided estimates that ranged from the effect of eliminating tax credits and cost-sharing reductions in 34 states to the decline in health spending for the 8.2 million people who would become uninsured if the Court judged that subsidies should not be available through state based exchanges. The Justice Department brief and eighteen amicus briefs cited these analyses, including the economists' brief that ultimately appeared extensively in the King majority opinion. One of the Urban briefs was also cited directly in the Court's majority opinion. The Urban analyses were developed to be accessible to a broad readership, which added to their utility. The Department of Justice turned to this body of work, while countless news organizations, commentators, and analysts across the country also used it to gauge the effects of the decision in their states.

"Each year, we see health services research play an instrumental role in informing evidence-based policy," said AcademyHealth President and CEO Dr. Lisa Simpson. "This year's HSR Impact Award is a testament to the role that this research played in one of the most preeminent issues in 2015. No issue in health care received more attention last year than King v. Burwell, so it is fitting that our winners this year informed that discussion through their research contributions."

The HSR Impact Award was presented at AcademyHealth's 2016 National Health Policy Conference, which convenes thought leaders and stakeholders from across the spectrum of health care to examine the most immediate and pressing policy priorities for the year ahead.
A full description of these bodies of work can be found on the AcademyHealth website at

About AcademyHealth

AcademyHealth is a leading national organization serving the fields of health services and policy research and the professionals who produce and use this important work. Together with our members, we offer programs and services that support the development and use of rigorous, relevant and timely evidence to increase the quality, accessibility, and value of health care, to reduce disparities, and to improve health. A trusted broker of information, AcademyHealth brings stakeholders together to address the current and future needs of an evolving health system, inform health policy, and translate evidence into action.