Demand for health insurance: Evidence from the California and Washington ACA exchanges.

I estimate demand for health insurance using consumer-level data from the California and Washington ACA exchanges. I use the demand estimates to simulate the impact of policies targeting adverse selection, including subsidies and the individual mandate. I find (1) own-premium elasticities of -7.2 to...

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Publicado en:Journal of Health Economics Vol. 63; pp. 197 - 223
Autor principal: Saltzman, Evan
Formato: Journal Article
Publicado: Elsevier B.V. Jan2019
Acceso en línea:Ver este registro en EBSCOhost
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      pub: Elsevier B.V.
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        10.1016/j.jhealeco.2018.11.004
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        atl: Demand for health insurance: Evidence from the California and Washington ACA exchanges.
      aug:
        au: Saltzman, Evan
        affil: Department of Economics, Emory University, 1602 Fishburne Drive, Atlanta, GA 30322, United States
      sug:
        subj:
          Health Insurance Exchanges Statistics and Numerical Data
          Health Services Needs and Demand Statistics and Numerical Data
          Patient Protection and Affordable Care Act Administration
          Insurance, Health Statistics and Numerical Data
          Infant
          Female
          Infant, Newborn
          Child
          Washington
          Child, Preschool
          Patient Protection and Affordable Care Act Statistics and Numerical Data
          California
          Male
          Young Adult
          Adolescence
          Adult
          Middle Age
          Clinical Assessment Tools
          Impact of Events Scale
          Infant: 1-23 months
          Infant, Newborn: birth-1 month
          Child: 6-12 years
          Child, Preschool: 2-5 years
          Adolescent: 13-18 years
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Female
          Male
      ab: I estimate demand for health insurance using consumer-level data from the California and Washington ACA exchanges. I use the demand estimates to simulate the impact of policies targeting adverse selection, including subsidies and the individual mandate. I find (1) own-premium elasticities of -7.2 to -10.6 and insurance coverage elasticities of -1.1 to -1.2; (2) limited response to the mandate penalty amount, but significant response to the penalty's existence, suggesting consumers have a "taste for compliance"; (3) mandate repeal slightly increases consumer surplus because the ACA's price-linked subsidies shield most consumers from premium increases resulting from repeal and some consumers are not compelled to purchase insurance against their will; and (4) mandate repeal decreases consumer surplus if ACA subsidies are replaced with vouchers that expose consumers to premium increases. The economic rationale for the mandate depends on the extent of adverse selection and the presence of other policies targeting selection.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
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