The Relationships of Competition and Demographics to the Pricing of Health Insurance Premiums in Affordable Care Act–Era Health Insurance Markets

2018 ◽  
Vol 37 (1) ◽  
pp. 88-105 ◽  
Author(s):  
Genevieve E. O'Connor
Keyword(s):  
Health Insurance ◽  
Affordable Care Act ◽  
Demographic Data ◽  
Insurance Coverage ◽  
Population Characteristics ◽  
Insurance Markets ◽  
Primary Concern ◽  
Insurance Premiums ◽  
Health Insurance Markets ◽  
Health Insurance Premiums

The Affordable Care Act (ACA) expands health insurance coverage to millions of Americans. Despite the act having been signed into law more than five years ago, health care affordability in the ACA era remains a topic of empirical inquiry, relevant to academicians and public policy makers. A primary concern, with implications for any future legislation, is whether all consumer groups have equitable access to health insurance options through ACA-mandated health insurance markets (HIMs). Utilizing pricing information and demographic data for states that adopted the Healthcare.gov platform, this study examines relationships between health insurance premiums, competition, and population characteristics. Results indicate that competition within HIMs is multifaceted. Although markets with a large number of insurance plans are associated with lower premiums, this effect is moderated by the concentration of insurers in the market and number of rating areas. Furthermore, population characteristics are related to premiums, where premiums vary by HIM demographics. Findings also suggest that access is less equitable in areas that have not adopted Medicaid expansion plans and areas that serve a large percentage of uninsured consumers.

Labor Market Consequences of State Mental Health Parity Mandates

2008 ◽  
Vol 11 (2) ◽  
Author(s):  
Attila Cseh
Keyword(s):  
Mental Health ◽  
Labor Market ◽  
Health Insurance ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
State Mental Health ◽  
Mental Health Parity ◽  
Insurance Premiums ◽  
Health Insurance Premiums ◽  
State Mental

This paper analyzes the effects of state mental health parity mandates on the labor and insurance markets. In particular, I investigate the effect of parity regulations along five margins: having employer provided health insurance coverage, employer contributions to health insurance premiums, the probability of full-time employment, working hours, and wages for a sample of private workers in firms with less than 100 employees using the Annual Demographic Surveys (March CPS) for the years 1999-2004 (and also in an extended sample of CPS 1992-2004). It is hypothesized that if parity mandates are costly they will have an impact on at least one of the above margins. I find no evidence for any of the most feared impact: a reduction in the probability of having employer-provided health insurance coverage or that state mental health parity mandates have decreased the generosity of employers' contributions to health insurance premiums. The results also lack any evidence of an impact on labor market composition or of costs having been passed onto workers in terms of lower wages.

scholarly journals After Midnight: A Regression Discontinuity Design in Length of Postpartum Hospital Stays

2011 ◽  
Vol 3 (3) ◽  
pp. 1-34 ◽  
Author(s):  
Douglas Almond ◽  
Joseph J Doyle
Keyword(s):  
Health Insurance ◽  
Insurance Coverage ◽  
Length Of Hospital Stay ◽  
Health Insurance Coverage ◽  
Insurance Markets ◽  
Regression Discontinuity Design ◽  
Insurance Mandates ◽  
Health Insurance Markets ◽  
Hospital Stays ◽  
Exogenous Source

Estimates of moral hazard in health insurance markets can be confounded by adverse selection. This paper considers a plausibly exogenous source of variation in insurance coverage for childbirth in California. We find that additional health insurance coverage induces substantial extensions in length of hospital stay for mother and newborn. However, remaining in the hospital longer has no effect on readmissions or mortality, and the estimates are precise. Our results suggest that for uncomplicated births, minimum insurance mandates incur substantial costs without detectable health benefits. (JEL D82, G22, I12, I18, J13)

Ten Years Later: Reflections on Critics' Worst-Case Scenarios for the Affordable Care Act

2020 ◽  
Vol 45 (4) ◽  
pp. 465-483
Author(s):  
Stacey McMorrow ◽  
Linda J. Blumberg ◽  
John Holahan
Keyword(s):  
Health Insurance ◽  
Affordable Care Act ◽  
Health Care Services ◽  
Insurance Coverage ◽  
Health Spending ◽  
Health Insurance Coverage ◽  
Worst Case ◽  
Care Services ◽  
Health Insurance Markets ◽  
The Affordable Care Act

Abstract The primary goals of the Affordable Care Act (ACA) were to increase the availability and affordability of health insurance coverage and thereby improve access to needed health care services. Numerous studies have overwhelmingly confirmed that the law has reduced uninsurance and improved affordability of coverage and care for millions of Americans. Not everyone believed that the ACA would lead to positive outcomes, however. Critics raised numerous concerns in the years leading up to the law's passage and full implementation, including about its consequences for national health spending, labor supply, employer health insurance markets, provider capacity, and overall population health. This article considers five frequently heard worst-case scenarios related to the ACA and provides research evidence that these fears did not come to pass.

scholarly journals The Questionable Value of Having a Choice of Levels of Health Insurance Coverage

2017 ◽  
Vol 31 (4) ◽  
pp. 51-72 ◽  
Author(s):  
Keith Marzilli Ericson ◽  
Justin Sydnor
Keyword(s):  
Health Insurance ◽  
Adverse Selection ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
The United States ◽  
Insurance Markets ◽  
Individual Level ◽  
Health Insurance Markets ◽  
Consumer Confusion ◽  
Multiple Levels

In most health insurance markets in the United States, consumers have substantial choice about their health insurance plan. However additional choice is not an unmixed blessing as it creates challenges related to both consumer confusion and adverse selection. There is mounting evidence that many people have difficulty understanding the value of insurance coverage, like evaluating the relative benefits of lower premiums versus lower deductibles. Also, in most US health insurance markets, people cannot be charged different prices for insurance based on their individual level of health risk. This creates the potential for well-known problems of adverse selection because people will often base the level of health insurance coverage they choose partly on their health status. In this essay, we examine how the forces of consumer confusion and adverse selection interact with each other and with market institutions to affect how valuable it is to have multiple levels of health insurance coverage available in the market.

scholarly journals Reforming reform: public assessments of the affordability of health insurance policies

2017 ◽  
Author(s):  
Sherry Glied ◽  
Peter Muennig
Keyword(s):  
Health Insurance ◽  
Affordable Care Act ◽  
Household Income ◽  
Telephone Survey ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Insurance Policies ◽  
Alternative Plan ◽  
Health Insurance Premiums ◽  
Dollar Amount

Background: Republicans have moved rapidly to repeal the Affordable Care Act, replacing progressive elements of the plan with regressive elements. We draw on an earlier affordability exercise to evaluate how Americans might view these elements of health care reform.Methods: Immediately prior to passage of the ACA, we conducted a telephone survey of a representative sample of U.S. households. Respondents were presented vignettes representing different insurance plans, each held by people with differing life characteristics. Respondents were then asked to assess the affordability of the presented plans given the characteristics of the policyholders. Results: Respondents felt that households should be expected to pay about 5% of income for health insurance coverage, irrespective of their income. They also tended to view older households as less able to afford coverage than younger households, and households with sicker occupants as less able to afford healthcare than households with healthy occupants. Results did not differ between respondents in red states and those in blue states.Conclusions: Most Americans, including those who reside in red states, believe that subsidies for health insurance premiums should be based on a fixed percentage of household income, not a fixed dollar amount. These perceptions may make it challenging to replace the ACA with a less costly alternative plan.

scholarly journals The COVID-19 Pandemic and Health Insurance Regulation

2021 ◽  
Vol 40 ◽  
Author(s):  
Joshua D. Frederick ◽  
J. Bradley Karl
Keyword(s):  
Health Insurance ◽  
Insurance Coverage ◽  
State Level ◽  
Health Insurance Coverage ◽  
Policy Implications ◽  
Insurance Markets ◽  
Insurance Regulation ◽  
Health Insurance Markets ◽  
Catastrophic Risks ◽  
Insight Into

With projections of costs in the billions for COVID-19 treatments alone, and heightened scrutiny on COVID-19-related health insurance coverage, the National Association of Insurance Commissioners (NAIC) convened in March 2020 to discuss how the industry could best deal with a pandemic. While the ramifications of the COVID-19 event are in their infant stages, it is important to consider the implications such catastrophic risks have on an insurance market. We evaluate state-level changes presented by the NAIC in response to the COVID-19 pandemic and use prior research to offer insight into health insurance in a post-COVID-19 world. This manuscript aims to provide a summary of the NAIC’s current standing during the pandemic, while presenting insight into policy implications regarding regulation in health insurance markets during catastrophic events.

scholarly journals The Effects of Employer-Sponsored Health Insurance Premiums on Employment and Wages: Evidence from US Longitudinal Data.

2020 ◽  
Vol 12 (1) ◽  
pp. 89-127
Author(s):  
Nicola Ciccarelli
Keyword(s):  
Labor Market ◽  
Health Insurance ◽  
Medical Malpractice ◽  
Private Health Insurance ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Market Outcomes ◽  
Insurance Premiums ◽  
The Us ◽  
Health Insurance Premiums

We analyze the effect of employer-sponsored health insurance premiums on employment and annual wages in the US using a county-level panel dataset for the period 2005-2010. Using variation in medical malpractice payments and variation in medical malpractice legislation over time and within states as the source of identifying variation in the health insurance premiums, we estimate the causal effects of rising health insurance premiums on employment and annual wages. We find that a 10% increase in premiums reduces employment by 1.1 percentage points, and leads to a statistically insignificant reduction of annual wages. Since US counties are characterized by a varying degree of private health insurance coverage, we also test whether the private health insurance coverage is a moderating variable for the relationship between the health insurance premiums and the labor market outcomes analyzed in this study. We find that rising premiums negatively affect the labor market conditions faced by US workers, especially in areas that are characterized by high private health insurance coverage.

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

Labor Market Concentration and Worker Contributions to Health Insurance Premiums

2021 ◽  
pp. 107755872110129
Author(s):  
Mark K. Meiselbach ◽  
Matthew D. Eisenberg ◽  
Ge Bai ◽  
Aditi Sen ◽  
Gerard F. Anderson
Keyword(s):  
Labor Market ◽  
Health Insurance ◽  
Labor Markets ◽  
Health Plan ◽  
Fixed Effects ◽  
Health Benefits ◽  
Market Concentration ◽  
Medical Expenditure ◽  
Insurance Premiums ◽  
Health Insurance Premiums

In concentrated labor markets, where workers have fewer employers to choose from, employers may exploit their monopsony power by contributing less to workers’ health benefits. This study examined if labor market concentration was associated with higher worker contributions to health plan premiums. We combined publicly available data from the Census to calculate labor market concentration and the Medical Expenditure Panel Survey Insurance/Employer Component to determine premium contributions from 2010 to 2016 for metropolitan areas. After controlling for year fixed-effects and market characteristics, we found that higher labor market concentration was associated with higher worker contributions to health plan premiums, lower take-home income, and no change in employer contributions to premiums, consistent with the hypothesis that greater labor market concentration is associated with less generous health benefits. When evaluating the effects of mergers and acquisitions on labor markets, regulatory agencies should critically assess worker contributions to health insurance premiums.

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