Impacts of shifting responsibility for high-cost individuals on Health Insurance Exchange plan premiums and cost-sharing provisions.

Insurance companies can respond to increases in expected per-capita healthcare expenditures by adjusting premiums, cost-sharing requirements, and/or plan generosity. We use a Difference-in-Difference model with Plan-level Fixed Effects to estimate the impacts of increases in expected expenditures ge...

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Publicado en:Journal of Health Economics Vol. 66; pp. 180 - 195
Autores principales: Mukhopadhyay, Sankar, Wendel, Jeanne, Zou, Miaomiao
Formato: Journal Article
Publicado: Elsevier B.V. Jul2019
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jul2019
      vid: 66
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      pub: Elsevier B.V.
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        137853108
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        10.1016/j.jhealeco.2019.05.004
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        atl: Impacts of shifting responsibility for high-cost individuals on Health Insurance Exchange plan premiums and cost-sharing provisions.
      aug:
        au:
          Mukhopadhyay, Sankar
          Wendel, Jeanne
          Zou, Miaomiao
        affil: Department of Economics, University of Nevada, Reno. 1664 N. Virginia St. Reno, NV, 89557, United States
      sug:
        subj:
          Insurance Methods
          Insurance Economics
          Health Insurance Exchanges Administration
          Insurance Statistics and Numerical Data
          Health Insurance Exchanges Economics
          United States
          Risk Management Methods
          Risk Management Economics
          Scales
      ab: Insurance companies can respond to increases in expected per-capita healthcare expenditures by adjusting premiums, cost-sharing requirements, and/or plan generosity. We use a Difference-in-Difference model with Plan-level Fixed Effects to estimate the impacts of increases in expected expenditures generated by closure of state-operated High Risk Pools (HRPs). For Silver plans, we find that issuers responded to HRP closures by increasing both premiums and deductibles, and by increasing the ratios of premiums to deductibles. This adjustment to the structure of plan prices is consistent with the hypothesis that issuers will be reluctant to adjust deductibles, because consumers tend to overweight changes in deductibles over changes in premiums. The increase in the ratio of premiums to deductibles indicates that the increase in expected expenditures triggered an increase in the share of total risk-pool healthcare expenditures paid by low healthcare utilizers, and a decrease in the share paid by high utilizers.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
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