Regulated Medicare Advantage And Marketplace Individual Health Insurance Markets Rely On Insurer Competition

2017 ◽  
Vol 36 (9) ◽  
pp. 1578-1584 ◽  
Author(s):  
Richard G. Frank ◽  
Thomas G. McGuire
Keyword(s):  
Health Insurance ◽  
Insurance Markets ◽  
Medicare Advantage ◽  
Individual Health ◽  
Health Insurance Markets

Community Rating And Sustainable Individual Health Insurance Markets In New Jersey

2004 ◽  
Vol 23 (4) ◽  
pp. 167-175 ◽  
Author(s):  
Alan C. Monheit ◽  
Joel C. Cantor ◽  
Margaret Koller ◽  
Kimberley S. Fox
Keyword(s):  
Health Insurance ◽  
New Jersey ◽  
Insurance Markets ◽  
Community Rating ◽  
Individual Health ◽  
Health Insurance Markets

scholarly journals Implications of family risk pooling for individual health insurance markets

2017 ◽  
Vol 17 (3-4) ◽  
pp. 219-236
Author(s):  
Anna D. Sinaiko ◽  
Timothy J. Layton ◽  
Sherri Rose ◽  
Thomas G. McGuire
Keyword(s):  
Health Insurance ◽  
Insurance Markets ◽  
Family Risk ◽  
Risk Pooling ◽  
Individual Health ◽  
Health Insurance Markets

Voluntary Private Health Insurance

2011 ◽  
pp. 284-307 ◽  
Author(s):  
Peter Zweifel
Keyword(s):  
Health Insurance ◽  
Private Health Insurance ◽  
Private Insurance ◽  
Health Sector ◽  
Future Research ◽  
Insurance Markets ◽  
Extensive Literature ◽  
Individual Health ◽  
Health Insurance Markets ◽  
Private Individual

The purpose of this article is to examine the working of voluntary private health insurance works. While empirical evidence on the functioning of voluntary private individual health insurance markets is lacking, there is a large and well-developed theoretical literature describing the functioning of private insurance markets in other sectors. This article begins by discussing this extensive literature and the working of such markets if they exist in the health sector. It considers the functioning of the three common forms of voluntary insurance, namely, individual health insurance markets, voluntary private coverage, and voluntary private health insurance that are auxiliary to public systems. Finally, the article proposes that a political economy based explanation for the existence of the theoretically optimal market does not exist and it concludes with areas for future research.

scholarly journals Selection in Health Insurance Markets and Its Policy Remedies

2017 ◽  
Vol 31 (4) ◽  
pp. 23-50 ◽  
Author(s):  
Michael Geruso ◽  
Timothy J. Layton
Keyword(s):  
Health Insurance ◽  
State Level ◽  
Decision Makers ◽  
Insurance Markets ◽  
Risk Selection ◽  
Medicare Advantage ◽  
Medium Term ◽  
Health Insurance Markets ◽  
The Common ◽  
Care Costs

Selection (adverse or advantageous) is the central problem that inhibits the smooth, efficient functioning of competitive health insurance markets. Even—and perhaps especially—when consumers are well-informed decision makers and insurance markets are highly competitive and offer choice, such markets may function inefficiently due to risk selection. Selection can cause markets to unravel with skyrocketing premiums and can cause consumers to be under- or overinsured. In its simplest form, adverse selection arises due to the tendency of those who expect to incur high health care costs in the future to be the most motivated purchasers. The costlier enrollees are more likely to become insured rather than to remain uninsured, and conditional on having health insurance, the costlier enrollees sort themselves to the more generous plans in the choice set. These dual problems represent the primary concerns for policymakers designing regulations for health insurance markets. In this essay, we review the theory and evidence concerning selection in competitive health insurance markets and discuss the common policy tools used to address the problems it creates. We emphasize the two markets that seem especially likely to be targets of reform in the short and medium term: Medicare Advantage (the private plan option available under Medicare) and the state-level individual insurance markets.

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