What has been the impact of the Affordable Care Act (2010) on healthcare coverage in the United States? While this significant piece of legislation put America’s healthcare system on a long-awaited path towards universal healthcare coverage, the struggle to provide coverage to millions of uninsured people is far from over.

This case describes a policy maker who is reviewing evidence on the financial and social impact of giving low-income families access to high-quality preschools. In doing so, the case presents details of the oft-cited Perry Preschool study, which used a randomized experiment design for impact evaluation and cost-benefit analysis of one such programme.