Interim Assessment of the Affordable Care Act

This page authored by Nathan Grawe, Carleton College.
Author Profile
This material was originally developed as part of the Carleton College Teaching Activity Collection
through its collaboration with the SERC Pedagogic Service.


This assignment invites students to synthesize what they have learned about the American health care system and the theory of health care economics through an examination of changes in health care since the passage of the Affordable Care Act (ACA). While the primary goal is to see what can be said already about the laws fulfillment of its stated goals, students will also come to understand the limitations of the data due to lags in data publication and changes in survey design.

Learning Goals

By completing this assignment students will demonstrate...
1) awareness of institutional details of the ACA
2) facility with economic models of health care
3) capacity to communicate economic theory
4) ability to support an argument with quantitative evidence presented in text, table, and graph
5) skill in working in teams.

Context for Use

This course (capped at 25 students) is a middle-level economics course taught at a selective liberal arts college. The course presumes a basic understanding of the principles of economics, but does not require calculus or intermediate theory courses. The assignment falls at the end of the course after students have studied economic theory and many institutional details of the American health care system and is intended as a "capstone" assignment that allows students to synthesize what they have learned in the course.

Description and Teaching Materials

This assignment handout includes all relevant materials including links to data resources: Student Handout for ACA Interim Assessment Assignment (Microsoft Word 2007 (.docx) 16kB Jul21 15).

This form allows students to provide feedback about teammates' contributions to the group's work: Peer Evaluation Form (Microsoft Word 2007 (.docx) 12kB Jul21 15).

Teaching Notes and Tips

The resources included are intended to be both broad and incomplete because that reflects the actual state of affairs in this area. For example, the government chose to change the monthly Current Population Survey (CPS) questions regarding health insurance coverage at the exact time the law was implemented. This makes the CPS a problematic source of data on changing coverage rates. The annual American Community Survey maintained a constant question format, but as of this date has no observations after the individual mandate took effect. This leaves us with survey data like that produced by Gallup. Another example: Metrics of health care "quality" are debatable and while the government is working on metrics for reimbursement none is available yet. So, in this case we have very indirect evidence like plan information gleaned from sites like

Present these limitations as positive aspects of assignment design (eg "Welcome to the complexity of the real world.") rather than as deficiencies in the assignment. This will help students come to understand the reality that we rarely get to work with the exact data we want.


While this is a group paper, I have asked each student in the team to take primary authorship of two sections to facilitate discrimination in grading. In addition, I ask students to evaluate teammates contributions to the whole.

Grading is based on:
- Accurate, effective, and insightful presentation of the empirical facts
- Clear and effective explanation of relevant economic theories
- Quality of writing.

References and Resources