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Health Reform, Health Insurance, and Selection: Estimating Selection into Health Insurance Using the Massachusetts Health Reform

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  • Martin B. Hackmann
  • Jonathan T. Kolstad
  • Amanda E. Kowalski

Abstract

We implement an empirical test for selection into health insurance using changes in coverage induced by the introduction of mandated health insurance in Massachusetts. Our test examines changes in the cost of the newly insured relative to those who were insured prior to the reform. We find that counties with larger increases in insurance coverage over the reform period face the smallest increase in average hospital costs for the insured population, consistent with adverse selection into insurance before the reform. Additional results, incorporating cross-state variation and data on health measures, provide further evidence for adverse selection.

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Bibliographic Info

Article provided by American Economic Association in its journal American Economic Review.

Volume (Year): 102 (2012)
Issue (Month): 3 (May)
Pages: 498-501

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Handle: RePEc:aea:aecrev:v:102:y:2012:i:3:p:498-501

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  1. מחקר - ביטוח לאומי, 2006. "Annual Survey 2005," Working Papers, National Insurance Institute of Israel 15, National Insurance Institute of Israel.
  2. David M. Cutler & Sarah Reber, 1996. "Paying for Health Insurance: The Tradeoff between Competition and Adverse Selection," NBER Working Papers 5796, National Bureau of Economic Research, Inc.
  3. Liran Einav & Amy Finkelstein & Mark R. Cullen, 2010. "Estimating Welfare in Insurance Markets Using Variation in Prices," The Quarterly Journal of Economics, MIT Press, MIT Press, vol. 125(3), pages 877-921, August.
  4. Jonathan T. Kolstad & Amanda E. Kowalski, 2010. "The Impact of Health Care Reform On Hospital and Preventive Care: Evidence from Massachusetts," NBER Working Papers 16012, National Bureau of Economic Research, Inc.
  5. Jonathan Gruber, 2011. "Massachusetts points the way to successful health care reform," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 30(1), pages 184-192, December.
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Cited by:
  1. Briggs Depew & James Bailey, . "Did the Affordable Care Act's Dependent Coverage Mandate Increase Premiums?," Departmental Working Papers, Department of Economics, Louisiana State University 2014-07, Department of Economics, Louisiana State University.
  2. Martin B. Hackmann & Jonathan T. Kolstad & Amanda E. Kowalski, 2013. "Adverse Selection and an Individual Mandate: When Theory Meets Practice," Cowles Foundation Discussion Papers, Cowles Foundation for Research in Economics, Yale University 1899, Cowles Foundation for Research in Economics, Yale University.
  3. Naoki Aizawa & Hanming Fang, 2013. "Equilibrium Labor Market Search and Health Insurance Reform," PIER Working Paper Archive 13-002, Penn Institute for Economic Research, Department of Economics, University of Pennsylvania.
  4. Andrew Beauchamp & Mathis Wagner, 2012. "Dying to Retire: Adverse Selection and Welfare in Social Security," Boston College Working Papers in Economics, Boston College Department of Economics 818, Boston College Department of Economics, revised 15 Aug 2013.
  5. Naoki Aizawa & Hanming Fang, 2013. "Equilibrium Labor Market Search and Health Insurance Reform," NBER Working Papers 18698, National Bureau of Economic Research, Inc.
  6. Jonathan T. Kolstad & Amanda E. Kowalski, 2012. "Mandate-Based Health Reform and the Labor Market: Evidence from the Massachusetts Reform," Cowles Foundation Discussion Papers, Cowles Foundation for Research in Economics, Yale University 1855, Cowles Foundation for Research in Economics, Yale University.
  7. Craig Garthwaite & Tal Gross & Matthew J. Notowidigdo, 2013. "Public Health Insurance, Labor Supply, and Employment Lock," NBER Working Papers 19220, National Bureau of Economic Research, Inc.

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