| 来源类型 | Working Paper |
| 规范类型 | 报告 |
| DOI | 10.3386/w29097 |
| 来源ID | Working Paper 29097 |
| Inertia, Market Power, and Adverse Selection in Health Insurance: Evidence from the ACA Exchanges | |
| Evan Saltzman; Ashley Swanson; Daniel Polsky | |
| 发表日期 | 2021-08-02 |
| 出版年 | 2021 |
| 语种 | 英语 |
| 摘要 | We study how inertia interacts with market power and adverse selection in managed competition health insurance markets. We use consumer-level data to estimate a model of the California ACA exchange, in which four firms dominate the market and risk adjustment is in place to manage selection. We estimate high inertia costs, equal to 44% of average premiums. Although eliminating inertia exacerbates adverse selection, it significantly reduces market power such that average premiums decrease 13.2% and annual per-capita welfare increases $902. These effects are substantially smaller in settings without market power and/or risk adjustment. Moreover, converting the ACA's premium-linked subsidies to vouchers mitigates the impact of inertia by reducing market power, whereas reducing high consumer churn in the ACA exchanges increases the impact of inertia by enhancing market power. The impact of inertia is not sensitive to provider network generosity, despite greater consumer attachment to plans with more differentiated provider networks. |
| 主题 | Financial Economics ; Financial Institutions ; Health, Education, and Welfare ; Health ; Industrial Organization ; Market Structure and Firm Performance |
| URL | https://www.nber.org/papers/w29097 |
| 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/586771 |
| 推荐引用方式 GB/T 7714 | Evan Saltzman,Ashley Swanson,Daniel Polsky. Inertia, Market Power, and Adverse Selection in Health Insurance: Evidence from the ACA Exchanges. 2021. |
| 条目包含的文件 | ||||||
| 文件名称/大小 | 资源类型 | 版本类型 | 开放类型 | 使用许可 | ||
| w29097.pdf（1927KB） | 智库出版物 | 限制开放 | CC BY-NC-SA | 浏览 | ||
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