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Does health insurance coverage fall when nonprofit insurers become for-profits?

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  • Lieber, Ethan M.J.

Abstract

In exchange for tax exemptions, Blue Cross and Blue Shield (BCBS) health insurers were expected to provide health insurance to the “bad risks,” those for whom coverage was unavailable from other insurers. I present evidence that five years after a BCBS plan converted to for-profit status, the probability of having insurance was 1.4 percentage points higher, a 9% reduction in the uninsured. The increase in coverage does not mask reductions among populations often targeted by public policies. However, there is evidence of increased risk selection which suggests that the bad risks might have been worse off after a conversion.

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  • Lieber, Ethan M.J., 2018. "Does health insurance coverage fall when nonprofit insurers become for-profits?," Journal of Health Economics, Elsevier, vol. 57(C), pages 75-88.
    • Handle: RePEc:eee:jhecon:v:57:y:2018:i:c:p:75-88
    DOI: 10.1016/j.jhealeco.2017.09.001
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    Cited by:

    1. Steve Cicala & Ethan M.J. Lieber & Victoria Marone, 2017. "Cost of Service Regulation in U.S. Health Care: Minimum Medical Loss Ratios," NBER Working Papers 23353, National Bureau of Economic Research, Inc.
    2. Steve Cicala & Ethan M. J. Lieber & Victoria Marone, 2019. "Regulating Markups in US Health Insurance," American Economic Journal: Applied Economics, American Economic Association, vol. 11(4), pages 71-104, October.

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    More about this item

    Keywords

    Nonprofit; Health insurance; Conversion; Risk selection;
    All these keywords.

    JEL classification:

    • L33 - Industrial Organization - - Nonprofit Organizations and Public Enterprise - - - Comparison of Public and Private Enterprise and Nonprofit Institutions; Privatization; Contracting Out
    • H25 - Public Economics - - Taxation, Subsidies, and Revenue - - - Business Taxes and Subsidies
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • L50 - Industrial Organization - - Regulation and Industrial Policy - - - General

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