How Initial Conditions Can Have Permanent Effects: The Case of the Affordable Care Act

• 成果类型: Article
• 署名作者: Scheuer, Florian; Smetters, Kent
• 署名单位: University of Zurich; University of Pennsylvania
• 刊物名称: AMERICAN ECONOMIC JOURNAL-ECONOMIC POLICY
• ISSN/ISSBN: 1945-7731
• DOI: 10.1257/pol.20140204
• 发表日期: 2018
• 页码: 302-343
• 关键词: insurance markets; adverse selection; health-insurance; competitive equilibria; INFORMATION; TRADE

摘要

We document that states that experienced website glitches in the ACA's first year faced higher average costs that persisted into future years. These dynamics are inconsistent with the standard strategic-pricing model, which requires non-localized common knowledge about market conditions, but are consistent with price-taking. Initial conditions can have a permanent effect-including convergence to a Pareto-dominated, stable equilibrium-under conditions that we show are plausible in this setting. Changing the fine from a fixed amount to a fraction of equilibrium prices increases the likelihood of reaching a Pareto-efficient equilibrium without increasing the equilibrium fine collected.