Interactive policy lab

Health Policy Simulator

Explore tradeoffs between coverage, cost, and access in U.S. health policy.

Baseline systems ACA, public option, single-payer, market-based Live browser-based Built with HTML, CSS, and JS

Compare the live configuration to the selected baseline, or lock a view side by side.

Policy settings

Adjust the policy settings.

Government subsidy 30% of premium

Higher subsidies lower the effective price of coverage and improve the risk pool.

Mandate strength Individual mandate

A stronger mandate improves enrollment and reduces adverse selection.

Provider reimbursement 100% of Medicare

Provider participation tends to fall quickly once rates dip below roughly 80% of Medicare.

Out-of-pocket maximum $8,700

A lower cap improves protection against catastrophic spending, especially for lower-income households.

Medicaid expansion threshold 138% FPL

Higher thresholds broaden eligibility and can reduce the uninsured rate quickly near the bottom of the income distribution.

Employer mandate threshold 50 employees

Lower thresholds make employer responsibility stronger and can stabilize coverage in the group market.

Current ACA baseline

This preset approximates a mixed public-private system with exchange subsidies, a mandate, Medicaid expansion, and provider payment close to Medicare rates.

Live policy outputs

Indexed against the selected baseline. Federal spending is shown as a relative index, with the current ACA baseline set to 100.

Mode Baseline comparison

Estimated uninsured rate 0.0% Compared with the chosen baseline

Benchmark premium $0 Annual sticker price for a benchmark plan

Federal spending index 100 100 = current ACA baseline

Provider participation 0% Proxy for network breadth and access

Wait time index 100 Higher values imply more pressure on access

Average burden 0.0% Weighted out-of-pocket burden across quintiles

Interpretation

The current baseline keeps coverage relatively stable while preserving broad provider participation.

Comparative model

Coverage, access, and fiscal balance

Current configuration versus the chosen baseline.

Distributional view

Out-of-pocket burden by income quintile

Percent of annual income, including premium and cost-sharing.

Locked configuration

Snapshot of the configuration that was locked for comparison.

Live configuration

The settings currently shown in the controls.

Methodology

This simulator uses stylized relationships drawn from standard health economics intuitions. It is not a microsimulation and does not claim predictive accuracy. The goal is to make policy tradeoffs legible.

Uninsured rate is modeled with an elasticity-style response to subsidies, mandate strength, Medicaid generosity, and employer responsibility. More generous coverage reduces the uninsured rate nonlinearly, with the biggest response at low subsidy and mandate levels.
Benchmark premium responds to the risk pool. When coverage improves and adverse selection falls, premiums ease. If the mandate weakens or the uninsured rate rises, premiums climb.
Provider participation falls sharply once reimbursement drops below roughly 80% of Medicare rates. Lower reimbursement reduces access even if it may temper spending growth.
Wait time is a simplified pressure index. It rises when more people are brought into the system without a matching increase in provider participation.
The federal spending index is normalized to the current ACA-like baseline. It is intended to compare directions and magnitudes, not to estimate dollar totals.
Out-of-pocket burden by income quintile is a stylized expected burden that combines premium exposure, cost-sharing, and uninsured risk. It does not include taxes or wage effects, which are critical in real policy analysis.

Presets are approximate archetypes: Current ACA, Medicare for All, Public Option, and Market-Based. Each can be fine-tuned with the sliders to see how small changes affect the same core tensions between coverage, cost, and access.