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Regulation of private health insurance markets: Lessons from enrollment, plan type choice, and adverse selection in Medicare Part D

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Author Info
Florian Heiss
Daniel McFadden
Joachim Winter

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Abstract

We study the Medicare Part D prescription drug insurance program as a bellwether for designs of private, non-mandatory health insurance markets that control adverse selection and assure adequate access and coverage. We model Part D enrollment and plan choice assuming a discrete dynamic decision process that maximizes life-cycle expected utility, and perform counterfactual policy simulations of the effect of market design on participation and plan viability. Our model correctly predicts high Part D enrollment rates among the currently healthy, but also strong adverse selection in choice of level of coverage. We analyze alternative designs that preserve plan variety.

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Publisher Info
Paper provided by National Bureau of Economic Research, Inc in its series NBER Working Papers with number 15392.

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Date of creation: Oct 2009
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Handle: RePEc:nbr:nberwo:15392

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Find related papers by JEL classification:
C25 - Mathematical and Quantitative Methods - - Single Equation Models; Single Variables - - - Discrete Regression and Qualitative Choice Models
D12 - Microeconomics - - Household Behavior - - - Consumer Economics: Empirical Analysis
H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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This page was last updated on 2009-11-25.

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