Sinking, Swimming, or Learning to Swim in Medicare Part D

2012 ◽  
Vol 102 (6) ◽  
pp. 2639-2673 ◽  
Author(s):  
Jonathan D Ketcham ◽  
Claudio Lucarelli ◽  
Eugenio J Miravete ◽  
M. Christopher Roebuck

Under Medicare Part D, senior citizens choose prescription drug insurance offered by numerous private insurers. We examine nonpoor enrollees' actions in 2006 and 2007 using panel data. Our sample reduced overspending by $298 on average, with gains by 81 percent of them. The greatest improvements were by those who overspent most in 2006 and by those who switched plans. Decisions to switch depended on individuals' overspending in 2006 and on individual-specific effects of changes in their current plans. The oldest consumers and those initiating medications for Alzheimer's disease improved by more than average, suggesting that real-world institutions help overcome cognitive limitations. (JEL D14, G22, H51, I13, I18)

2020 ◽  
Vol 12 (1) ◽  
pp. 389-417
Author(s):  
Gal Wettstein

I examine whether lack of an individual market for prescription drug insurance causes individuals to delay retirement. Exploiting the 2006 introduction of Medicare Part D, which subsidized drug insurance for Americans over age 65, I use a triple-differences design that compares labor outcomes of individuals with retiree health insurance up to age 65 to those with insurance for life, before and after age 65, before and after 2006. I find that those with benefits only to age 65 decreased full-time work by 8.4 percentage points, of which 70 percent was due to transitions to part-time work. (JEL G22, H51, I13, I18, J14, J26)


2014 ◽  
Vol 6 (1) ◽  
pp. 38-64 ◽  
Author(s):  
Keith M. Marzilli Ericson

I use the Medicare Part D prescription drug insurance market to examine the dynamics of firm interaction with consumers on an insurance exchange. Enrollment data show that consumers face switching frictions leading to inertia in plan choice, and a regression discontinuity design indicates initial defaults have persistent effects. In the absence of commitment to future prices, theory predicts firms respond to inertia by raising prices on existing enrollees, while introducing cheaper alternative plans. The complete set of enrollment and price data from 2006 through 2010 confirms this prediction: older plans have approximately 10 percent higher premiums than comparable new plans. (JEL G22, I13, I18, L11, L65)


2011 ◽  
Vol 3 (4) ◽  
pp. 77-102 ◽  
Author(s):  
Gary V Engelhardt ◽  
Jonathan Gruber

We examine the impact of the expansion of public prescription-drug insurance coverage from Medicare Part D and find evidence of substantial crowd-out. Using the 2002–2007 waves of the Medical Expenditure Panel Survey, we estimate the extension of Part D benefits resulted in 75 percent crowd-out of both prescription-drug insurance coverage and expenditures of those 65 and older. Part D is associated with sizeable reductions in out-of-pocket spending, much of which has accrued to a small proportion of the elderly. On average, we estimate a welfare gain from Part D comparable to the deadweight cost of program financing. (JEL H51, I18, J14)


2015 ◽  
Vol 105 (1) ◽  
pp. 204-233 ◽  
Author(s):  
Jonathan D. Ketcham ◽  
Claudio Lucarelli ◽  
Christopher A. Powers

We study whether people became less likely to switch Medicare prescription drug plans (PDPs) due to more options and more time in Part D. Panel data for a random 20 percent sample of enrollees from 2006–2010 show that 50 percent were not in their original PDPs by 2010. Individuals switched PDPs in response to higher costs of their status quo plans, saving them money. Contrary to choice overload, larger choice sets increased switching unless the additional plans were relatively expensive. Neither switching overall nor responsiveness to costs declined over time, and above-minimum spending in 2010 remained below the 2006 and 2007 levels. (JEL H51, I13, I18)


2015 ◽  
Vol 42 (2) ◽  
pp. 170-185 ◽  
Author(s):  
David Zimmer

Purpose – The US Medicare Modernization Act of 2003 introduced optional prescription drug coverage, beginning in 2006, widely known as Medicare Part D. This paper uses up-to-date nationally representative survey data to investigate the impact of Part D not only on drug spending and consumption, but also on the composition of drug consumption. The paper aims to discuss these issues. Design/methodology/approach – Specifically, the paper investigates whether Part D impacted the number of therapeutic classes for which drugs were prescribed, and also whether Part D lead to increased usage of drugs for specific medical conditions that typically receive drug-intensive therapies. Findings – In addition to confirming findings from previous studies, this paper shows that Part D increased the number of therapeutic classes to which seniors receive drugs by approximately four classes. Part D also lead to increased usage of drugs used to treat upper respiratory disease, hypertension, and diabetes. Originality/value – While mostly concurring with previous studies on the spending impacts of Part D, this paper is the first to shed light on other impacts of Part D, specifically with respect to its impact on therapeutic classes for which drugs are prescribed.


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