全球智库信息集成服务系统(G2TT): Adverse Selection and an Individual Mandate: When Theory Meets Practice

G2TT

来源类型	Working Paper
规范类型	报告
DOI	10.3386/w19149
来源ID	Working Paper 19149
	Adverse Selection and an Individual Mandate: When Theory Meets Practice
	Martin B. Hackmann; Jonathan T. Kolstad; Amanda E. Kowalski
发表日期	2013-06-20
出版年	2013
语种	英语
摘要	We develop a model of selection that incorporates a key element of recent health reforms: an individual mandate. We identify a set of key parameters for welfare analysis, allowing us to model the welfare impact of the actual policy as well as to estimate the socially optimal penalty level. Using data from Massachusetts, we estimate the key parameters of the model. We compare health insurance coverage, premiums, and insurer average health claim expenditures between Massachusetts and other states in the periods before and after the passage of Massachusetts health reform. In the individual market for health insurance, we find that premiums and average costs decreased significantly in response to the individual mandate; consistent with an initially adversely selected insurance market. We are also able to recover an estimated willingness-to-pay for health insurance. Combining demand and cost estimates as sufficient statistics for welfare analysis, we find an annual welfare gain of $335 dollars per person or $71 million annually in Massachusetts as a result of the reduction in adverse selection. We also find evidence for smaller post-reform markups in the individual market, which increased welfare by another $107 dollars per person per year and about $23 million per year overall. To put this in perspective, the total welfare gains were 8.4% of medical expenditures paid by insurers. Our model and empirical estimates suggest an optimal mandate penalty of $2,190. A penalty of this magnitude would increase health insurance to near universal levels. Our estimated optimal penalty is higher than the individual mandate penalty adopted in Massachusetts but close to the penalty implemented under the ACA.
主题	Health, Education, and Welfare ; Health
URL	https://www.nber.org/papers/w19149
来源智库	National Bureau of Economic Research (United States)
引用统计
资源类型	智库出版物
条目标识符	http://119.78.100.153/handle/2XGU8XDN/576823
推荐引用方式 GB/T 7714	Martin B. Hackmann,Jonathan T. Kolstad,Amanda E. Kowalski. Adverse Selection and an Individual Mandate: When Theory Meets Practice. 2013.