Adverse Selection and an Individual Mandate: When Theory Meets Practice

• 成果类型: Article
• 署名作者: Hackmann, Martin B.; Kolstad, Jonathan T.; Kowalski, Amanda E.
• 署名单位: Pennsylvania Commonwealth System of Higher Education (PCSHE); Pennsylvania State University; Pennsylvania State University - University Park; University of Pennsylvania; Yale University
• 刊物名称: AMERICAN ECONOMIC REVIEW
• ISSN/ISSBN: 0002-8282
• DOI: 10.1257/aer.20130758
• 发表日期: 2015
• 页码: 1030-1066
• 关键词: HEALTH-CARE REFORM; insurance markets; welfare; IMPACT

摘要

We develop a model of selection that incorporates a key element of recent health reforms: an individual mandate. Using data from Massachusetts, we estimate the parameters of the model. In the individual market for health insurance, we find that premiums and average costs decreased significantly in response to the individual mandate. We find an annual welfare gain of 4.1 percent per person or $51.1 million annually in Massachusetts as a result of the reduction in adverse selection. We also find smaller post-reform markups.