How Did Take-Up of Marketplace Plans Vary with Price, Income, and Gender?

We estimate the demand for subsidized insurance in the Affordable Care Act marketplaces using administrative enrollment data for the 39 states that used Healthcare.gov between 2015 and 2017. Our results expand the existing literature on marketplace take-up, the extensive margin, in several important...

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Publicado en:American Journal of Health Economics Vol. 11; no. 1; pp. 63 - 91
Autores principales: Hopkins, Benjamin, Banthin, Jessica, Minicozzi, Alexandra
Formato: equations & formulas pictorial research tables/charts Journal Article
Publicado: University of Chicago Press Winter2025
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Winter2025
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        10.1086/727785
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        atl: How Did Take-Up of Marketplace Plans Vary with Price, Income, and Gender?
      aug:
        au:
          Hopkins, Benjamin
          Banthin, Jessica
          Minicozzi, Alexandra
      sug:
        subj:
          Health Insurance Exchanges Economics
          Income
          Sex Factors
          Insurance Coverage
          Human
          Male
          Female
          Adult
          Middle Age
          United States Centers for Medicare and Medicaid Services
          Surveys
          Insurance
          Women's Health
          Age Factors
          Sensitivity and Specificity
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Male
          Female
      ab: We estimate the demand for subsidized insurance in the Affordable Care Act marketplaces using administrative enrollment data for the 39 states that used Healthcare.gov between 2015 and 2017. Our results expand the existing literature on marketplace take-up, the extensive margin, in several important ways. First, we provide the first estimates of price elasticities based on administrative data from states with Federally Facilitated Marketplaces, which accounted for three-quarters of all marketplace enrollment and include states that did not expand Medicaid. Our estimates suggest that price elasticities may be lower in our sample of states than in states such as California (a major data source for other studies), which expanded Medicaid and pursued policies that may have increased price sensitivity. Our analysis also yields new evidence suggesting that many people in the coverage gap in non-expansion states obtain subsidies by reporting income just above the federal poverty line at the time of enrollment, especially in Florida. Finally, we update the existing literature describing higher demand for insurance coverage by women by estimating the difference in take-up rates by gender while controlling for eligibility for subsidies, finding that these gender differences persist among both young and older adults.
      pubtype: Academic Journal
      doctype:
        equations & formulas
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      ougenre: Article
    language: English
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