Spillover Effects of Medicaid Expansion on Private Premiums - read free eBook in online reader or directly download on the web page. Select files or add your book in reader. Download and read online ebook Spillover Effects of Medicaid Expansion on Private Premiums write by Cameron Ellis. This book was released on 2019. Spillover Effects of Medicaid Expansion on Private Premiums available in PDF, EPUB and Kindle. The Affordable Care Act is one of the most debated and dividing pieces of legislation in recent memory. One of the main elements of the ACA is the optional expansion of Medicaid eligibility to 138 % of the federal poverty line. The current debate has focused on the direct effects of the newly covered vs. the accounting cost of doing so, but there are also important other spillover effects to consider. In states that refused the Medicaid expansion, there exists a coverage gap that the private market will, at least partially, pick up. This gap, and the portion picked up, are not random and systematically exhibit higher expected costs. This raises prices for everyone taking part in the health insurance exchanges in states that refused the expansion. Our contribution is three-fold. We first confirm the interaction between the individual market and Medicaid expansion. We find that refusing the Medicaid expansion increases average monthly premiums by $22.94, an increase of 7.6 %. Our second and third contributions are more novel. We use a sharp discontinuity in the subsidy rates and find the premium increase is due to asymmetric information arising from the cost sharing reduction subsidies. We also provide a clean estimation of -0.34 for the price elasticity of healthcare in a pseudo-random experimental setting. Finally, we are able to separate the asymmetric information effect into adverse selection and moral hazard and find the moral hazard effect dominates.
The Relationship Between Medicaid Expansion and Premiums in the Individual Market: A County-Level Analysis
The Relationship Between Medicaid Expansion and Premiums in the Individual Market: A County-Level Analysis - read free eBook in online reader or directly download on the web page. Select files or add your book in reader. Download and read online ebook The Relationship Between Medicaid Expansion and Premiums in the Individual Market: A County-Level Analysis write by Emma Chapman. This book was released on 2018. The Relationship Between Medicaid Expansion and Premiums in the Individual Market: A County-Level Analysis available in PDF, EPUB and Kindle. The Patient Protection and Affordable Care Act (ACA) was designed to increase access to affordable health coverage by reforming the individual health insurance market and expanding eligibility for Medicaid, the insurance program targeted towards low-income individuals. Since its passage, however, the ACA has been plagued by criticisms that it has produced significant premium hikes. Moreover, many states chose not to expand their Medicaid programs. I examine whether there is a relationship between Medicaid expansion decisions and insurance premiums in the individual market. Because Medicaid expansions remove lower income individuals from individual insurance markets - and since these individuals tend to have poorer health outcomes - premiums in the private insurance market could be lower in expansion states where the private market is priced for a healthier risk pool. My results indicate that this may not be the case: I find that there is a positive and statistically significant relationship between Medicaid expansion and premiums, although this relationship is small in magnitude. I also find, however, that the relationship is the opposite for states that retained some measure of control over the administration of their marketplaces. This finding makes a novel contribution to the literature by demonstrating how state-level policy decisions can impact the success of national legislation. My study also illustrates the need for additional research into the impact of Medicaid expansions on premiums, as studies conducted to date have found contradicting results.
Handbook of Health Economics
Handbook of Health Economics - read free eBook in online reader or directly download on the web page. Select files or add your book in reader. Download and read online ebook Handbook of Health Economics write by Mark V. Pauly. This book was released on 2012-01-05. Handbook of Health Economics available in PDF, EPUB and Kindle. "As a relatively new subdiscipline of economics, health economics has made many contributions to areas of the main discipline, such as insurance economics. This volume provides a survey of the burgeoning literature on the subject of health economics." {source : site de l'éditeur].
A Shared Destiny
A Shared Destiny - read free eBook in online reader or directly download on the web page. Select files or add your book in reader. Download and read online ebook A Shared Destiny write by Institute of Medicine. This book was released on 2003-03-05. A Shared Destiny available in PDF, EPUB and Kindle. A Shared Destiny is the fourth in a series of six reports on the problems of uninsurance in the United States. This report examines how the quality, quantity, and scope of community health services can be adversely affected by having a large or growing uninsured population. It explores the overlapping financial and organizational basis of health services delivery to uninsured and insured populations, the effects of community uninsurance on access to health care locally, and the potential spillover effects on a community's economy and the health of its citizens. The committee believes it is both mistaken and dangerous to assume that the persistence of a sizable uninsured population in the United States harms only those who are uninsured.
Three Essays in Health Economics and Industrial Organization
Three Essays in Health Economics and Industrial Organization - read free eBook in online reader or directly download on the web page. Select files or add your book in reader. Download and read online ebook Three Essays in Health Economics and Industrial Organization write by Jee-Hun Choi. This book was released on 2020. Three Essays in Health Economics and Industrial Organization available in PDF, EPUB and Kindle. This dissertation consists of three essays in the field of health economics and industrial organization, focusing on the policies on public health insurance in the United States. The first chapter investigates the impact of expanding public health insurance through private insurers on equilibrium insurance market outcomes. Using the Arkansas All-Payer Claims Database, I measure the impact of the Affordable Care Act (ACA) insurance expansions on hospital reimbursement rates and premiums for non-ACA private plans, including employer-sponsored insurance plans not directly affected by the ACA. Using a Nash bargaining model based on the Ho and Lee (2017) framework, I find that the publicly-subsidized expansion decreases hospital reimbursement rates by 5.3% and insurance premiums by 0.6% for privately-insured enrollees who are not covered by the ACA. This spillover effect on reimbursement rates is driven by the increased bargaining leverage of insurers participating in the expansion. The increase in leverage results mainly from the change in the composition of enrollees, which goes hand-in-hand with enrollment increase as a result of the expansion. The second chapter, co-authored with Claire Lim, explores the linkages between government ideology in U.S. states and geographic variation in Medicaid program design and operations. Medicaid eligibility criteria tend to be more generous in liberal states. Simultaneously, fee-for-service reimbursement rates for physician services have been notably lower in liberal states. These two patterns lead to the following question: to what extent does the partisan composition of the government drive eligibility and reimbursement over time? If cost-saving measures accompany eligibility expansion, then what are their consequences for resource allocation? We explore long-run linkages among partisan composition of the government, eligibility, cost-saving measures, and expenditures for the Medicaid expansion from the mid-1990s to 2010. Our analysis consists of four steps. First, we analyze how much the partisan composition of the state government drives eligibility expansion. Second, we explore the tradeoff between breadth of eligibility and fee-for-service reimbursement rates. Third, we investigate driving forces behind the evolution of the delivery systems, i.e., Medicaid managed care diffusion. Fourth, we analyze the resulting patterns of per-enrollee spending. We find that the partisan composition of the state house played a critical role in the relatively later stage of eligibility expansion and the reduction of fee-for-service reimbursement rates over time. While the HMO penetration in the private insurance market drove the Medicaid managed care diffusion, the diffusion also tends to go hand in hand with the reduction of fee-for-service reimbursement rates. Finally, Medicaid per-enrollee spending increased substantially over time despite the adoption of cost-saving measures. This unintended consequence was due to the systematic changes in HMO practices that coincided with the eligibility expansion. The third chapter, co-authored with Claire Lim, investigates determinants of government subsidy in the U.S. health care industry, focusing on the Medicaid Disproportionate Share Hospital (DSH) program. We find that the amount of Medicaid DSH payment per bed increases significantly with increase in hospital size for government hospitals. This is partially explained by the distinctive role that large government hospitals play in the provision of care to the indigent population. However, costs, financial conditions, or types of services by themselves are not enough to explain DSH payments. Large government hospitals tend to have a higher ratio of DSH payments to Medicaid and uninsured costs. The difference in the DSH payment-to-cost ratio across ownership types increases significantly with increase in hospital size. We argue that these key patterns are unlikely to be driven by unobserved heterogeneity, using the Altonji-Elder-Taber-Oster method. Our results on payment-to-cost ratios are consistent with targeting by the state government to counterbalance disparities in hospitals' capability to cross-subsidize across patient types.
