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The COMPARE microsimulation model and the U.S. Affordable Care Act

  1. Amado Cordova  Is a corresponding author
  2. Federico Girosi
  3. Sarah Nowak
  4. Christine Eibner
  5. Kenneth Finegold
  1. RAND Corporation, United States
  2. Centre for Health Research, University of Western Sydney, Australia
  3. U.S. Department of Health and Human Services, United States
Research article
Volume 6(3) Winter 2013
Cite this article as: A. Cordova, F. Girosi, S. Nowak, C. Eibner, K. Finegold; 2013; The COMPARE microsimulation model and the U.S. Affordable Care Act; International Journal of Microsimulation; 6(3); 78-117. doi: 10.34196/ijm.00089
2 figures and 3 tables

Figures

Figure 1
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How COMPARE creates a synthetic representation of the U.S. from its data sources.
Figure 2
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Schematic representation of the reweight-calibrate-run or RCR procedure.

Tables

Table 1
U.S. Health insurance coverage in 2012.
Type of coverage Who is covered Funding source Number (in millions) Percentage of the population
Employer-sponsored insurance Employees of offering firms and their family members Employer and employee contributions 170.9 54.9%
Private Nongroup (also known as “individual market”) Individuals and families purchasing coverage Individual premiums 30.6 9.8%
Medicaid/CHIP Low-income children, parents, elderly, and disabled; childless nondisabled adults are eligible in some states Federal government and states; counties share financial responsibility in some states 50.9 16.4%
Medicare Elderly and disabled Federal government 48.9 15.7%
Military Current members of the armed forces and their families, veterans Federal government 13.7 4.4%
Uninsured N/A N/A 48.0 15.4%
TOTAL 311.1 116.7%

  1. Note: Percentages total more than 100.0% because some Current Population Survey Annual Social and Economic Supplement (CPS-ASEC) respondents reported more than one type of coverage during Calendar Year 2012.

    Source: Carmen DeNavas-Walt, Bernadette D. Proctor, and Jessica C. Smith, U.S. Census Bureau, Current Population Reports, P60–245, Income, Poverty, and Health Insurance Coverage in the United States: 2012, U.S. Government Printing Office, Washington, DC, 2013, p. 67.

Table 2
Medical loss ratio assumptions in compare.
Pre-Reform, Grandfathered, and Large Group Plans Post-Reform, Regulated market
Group Market
< 25 0.80 0.88
26–100 0.87 0.88
101 + 0.92 NA
Non-group market 0.70 0.80

  1. Note: NA means not applicable, since the MLRs of firms with 101+ employees are not modified by the Affordable Care Act.

Table 3
Comparison of compare and CBO national-level coverage estimates for the non-elderly U.S. population in the year 2016 (in millions).
Insurance Coverage CBO (no ACA) CBO (ACA) CBO (change due to ACA) COMPARE (no ACA) COMPARE (ACA) COMPARE (Change due to ACA)
Medicaid and CHIP 33 45 12 46 62 16
Employer sponsored 161 155 −6 154 154 0
Non-group and Other 26 22 −4 24 12 −12
Individual Exchanges NA 22 22 NA 26 26
Uninsured 56 31 −25 52 23 −29

  1. Note: ACA=Affordable Care Act.

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