Overview

• The law’s implementation in 2022 was linked to nearly $600 in average annual out-of-pocket savings per patient in states that newly gained protections.
• No similar decline appeared in states with preexisting comprehensive protections, based on claims from 17,351 directly insured adults aged 19–64.
• Premium spending did not change, contrary to expectations that arbitration rules would lower monthly costs.
• Rates of high-burden medical spending—more than 10% of family income—showed no meaningful improvement.
• Researchers pointed to anecdotal provider tactics, including among private equity–backed groups, and urged continued monitoring and policy fixes.