Managing adverse selection: underinsurance versus underenrollment.

Adverse selection in insurance markets may lead some consumers to underinsure or too few consumers to purchase insurance relative to the socially optimal level. I study whether common government policy interventions can mitigate both underinsurance and underenrollment due to adverse selection. I est...

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Bibliographic Details
Published in:RAND Journal of Economics (Wiley-Blackwell) Vol. 52; no. 2; pp. 359 - 382
Main Author: Saltzman, Evan
Format: Article
Published: Wiley-Blackwell Jun2021
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Online Access:View this record in EBSCOhost
Description
Summary:Adverse selection in insurance markets may lead some consumers to underinsure or too few consumers to purchase insurance relative to the socially optimal level. I study whether common government policy interventions can mitigate both underinsurance and underenrollment due to adverse selection. I establish conditions under which there exists a tradeoff in addressing underinsurance and underenrollment. I then estimate a model of the California ACA insurance exchange using consumer‐level data to quantify the welfare impact of risk adjustment and the individual mandate. I find (1) risk adjustment reduces underinsurance, but reduces enrollment and (2) the mandate increases enrollment, but increases underinsurance.