Estimating Equilibrium in Health Insurance Exchanges: Price Competition and Subsidy Design under the ACA.
Regulations to design private yet publicly sponsored health insurance markets are increasingly adopted in many OECD countries. Here I combine data and economic theory to analyse the interaction between insurers' competition and the design of premium subsidies in determining equilibrium outcomes. My...
| Publicado en: | Review of Economic Studies Vol. 92; no. 1; pp. 586 - 621 |
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| Formato: | Artículo |
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Oxford University Press / USA
Jan2025
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ssf&AN=182368145&site=ehost-live header: @attributes: shortDbName: ssf uiTerm: 182368145 longDbName: Social Sciences Full Text (H.W. Wilson) uiTag: AN controlInfo: bkinfo: jinfo: jid: 00346527 REM jtl: Review of Economic Studies issn: 00346527 maglogo: N pubinfo: dt: Jan2025 vid: 92 iid: 1 pid: 622 pub: Oxford University Press / USA artinfo: ui: 182368145 10.1093/restud/rdae020 ppf: 586 ppct: 35 formats: tig: atl: Estimating Equilibrium in Health Insurance Exchanges: Price Competition and Subsidy Design under the ACA. aug: au: Tebaldi, Pietro affil: Department of Economics, Columbia University and NBER, USA su: Health insurance exchanges Insurance companies Patient Protection & Affordable Care Act Economic statistics Health care reform sug: subj: Other Direct Insurance (except Life, Health, and Medical) Carriers Direct Health and Medical Insurance Carriers Direct group life, health and medical insurance carriers Insurance Agencies and Brokerages Health insurance exchanges Insurance companies Patient Protection & Affordable Care Act Economic statistics Health care reform keyword: ACA Health exchanges Health insurance Healthcare reform Subsidies ACA Health exchanges Health insurance Healthcare reform Subsidies ab: Regulations to design private yet publicly sponsored health insurance markets are increasingly adopted in many OECD countries. Here I combine data and economic theory to analyse the interaction between insurers' competition and the design of premium subsidies in determining equilibrium outcomes. My empirical model includes adverse selection, rich heterogeneity in preferences for vertically and horizontally differentiated plans and accommodates alternative assumptions on pricing conduct. In the context of the Affordable Care Act in the U.S. I estimate the joint distribution of preferences and expected cost using Californian administrative records on 3.4 million plan choices between 2014 and 2017, combined with plan and survey data on medical claims. An empirical horse race between conduct assumptions favours oligopoly pricing over perfect competition. Considering alternative subsidy designs shows that, in equilibrium, shifting subsidy generosity toward the "young invincibles" would lower premiums for all enrolees while increasing enrolment and profits. pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: N holdings: @attributes: islocal: N |
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