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Health Insurance Design Meets Saving Incentives: Consumer Responses to Complex Contracts

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  • Adam Leive

Abstract

To lower health care costs, Health Savings Accounts (HSAs) offer tax incentives encouraging people to trade off current consumption against future consumption. This paper tests whether consumers use HSAs as self-insurance over the life cycle. Using administrative data from a large employer and a regression discontinuity design, I estimate the marginal propensity to consume from HSA assets is 0.85 and reject the neoclassical benchmark of 0. Comparisons with 401(k) saving show most employees do not treat HSA money as fungible with retirement savings. In this setting, HSAs did not reduce health spending and instead increased the share that was financed tax-free.

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  • Adam Leive, 2022. "Health Insurance Design Meets Saving Incentives: Consumer Responses to Complex Contracts," American Economic Journal: Applied Economics, American Economic Association, vol. 14(2), pages 200-227, April.
    • Handle: RePEc:aea:aejapp:v:14:y:2022:i:2:p:200-227
    DOI: 10.1257/app.20200135
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    References listed on IDEAS

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    1. Benjamin R. Handel & Jonathan T. Kolstad, 2015. "Health Insurance for "Humans": Information Frictions, Plan Choice, and Consumer Welfare," American Economic Review, American Economic Association, vol. 105(8), pages 2449-2500, August.
    2. M. Daniele Paserman, 2008. "Job Search and Hyperbolic Discounting: Structural Estimation and Policy Evaluation," Economic Journal, Royal Economic Society, vol. 118(531), pages 1418-1452, August.
    3. Damon Jones & Aprajit Mahajan, 2015. "Time-Inconsistency and Saving: Experimental Evidence from Low-Income Tax Filers," NBER Working Papers 21272, National Bureau of Economic Research, Inc.
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    Cited by:

    1. Huang, Wei & Lei, Xiaoyan & Ta, Yuqi, 2024. "How does undervaluation in medical savings accounts (MSAs) affect healthcare utilization? Evidence from administrative data in China," Journal of Health Economics, Elsevier, vol. 98(C).

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    More about this item

    JEL classification:

    • D15 - Microeconomics - - Household Behavior - - - Intertemporal Household Choice; Life Cycle Models and Saving
    • D82 - Microeconomics - - Information, Knowledge, and Uncertainty - - - Asymmetric and Private Information; Mechanism Design
    • G22 - Financial Economics - - Financial Institutions and Services - - - Insurance; Insurance Companies; Actuarial Studies
    • G51 - Financial Economics - - Household Finance - - - Household Savings, Borrowing, Debt, and Wealth
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private

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