Nonparametric Estimates of Demand in the California Health Insurance Exchange.

We develop a new nonparametric approach for discrete choice and use it to analyze the demand for health insurance in the California Affordable Care Act marketplace. The model allows for endogenous prices and instrumental variables, while avoiding parametric functional form assumptions about the unob...

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Publicado en:Econometrica Vol. 91; no. 1; pp. 107 - 147
Autores principales: Tebaldi, Pietro, Torgovitsky, Alexander, Yang, Hanbin
Formato: Artículo
Publicado: Wiley-Blackwell Jan2023
Materias:
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jan2023
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      pub: Wiley-Blackwell
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        10.3982/ECTA17215
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        atl: Nonparametric Estimates of Demand in the California Health Insurance Exchange.
      aug:
        au:
          Tebaldi, Pietro
          Torgovitsky, Alexander
          Yang, Hanbin
        affil:
          Department of Economics, Columbia University
          NBER
          Kenneth C. Griffin Department of Economics, University of Chicago
          Harvard Business School
      su:
        California
        Health insurance exchanges
        Consumers' surplus
        Patient Protection & Affordable Care Act
        Price sensitivity
        Logistic regression analysis
      sug:
        subj:
          California
          Health insurance exchanges
          Consumers' surplus
          Patient Protection & Affordable Care Act
          Price sensitivity
          Logistic regression analysis
      keyword:
        ACA
        demand estimation
        discrete choice models
        health insurance
        linear programming
        Nonparametric estimation
        partial identification
        ACA
        demand estimation
        discrete choice models
        health insurance
        linear programming
        Nonparametric estimation
        partial identification
      ab: We develop a new nonparametric approach for discrete choice and use it to analyze the demand for health insurance in the California Affordable Care Act marketplace. The model allows for endogenous prices and instrumental variables, while avoiding parametric functional form assumptions about the unobserved components of utility. We use the approach to estimate bounds on the effects of changing premiums or subsidies on coverage choices, consumer surplus, and government spending on subsidies. We find that a $10 decrease in monthly premium subsidies would cause a decline of between 1.8% and 6.7% in the proportion of subsidized adults with coverage. The reduction in total annual consumer surplus would be between $62 and $74 million, while the savings in yearly subsidy outlays would be between $207 and $602 million. We estimate the demand impacts of linking subsidies to age, finding that shifting subsidies from older to younger buyers would increase average consumer surplus, with potentially large impacts on enrollment. We also estimate the consumer surplus impact of removing the highly‐subsidized plans in the Silver metal tier, where we find that a nonparametric model is consistent with a wide range of possibilities. We find that comparable mixed logit models tend to yield price sensitivity estimates toward the lower end of the nonparametric bounds, while producing consumer surplus impacts that can be both higher and lower than the nonparametric bounds depending on the specification of random coefficients.
      pubtype: Academic Journal
      doctype: Article
      src: R
    language: English
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