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How Initial Conditions Can Have Permanent Effects: The Case of the Affordable Care Act

Author

Listed:
  • Florian Scheuer
  • Kent Smetters

Abstract

We document that states that experienced website glitches in the ACA's first year faced higher average costs that persisted into future years. These dynamics are inconsistent with the standard strategic-pricing model, which requires non-localized common knowledge about market conditions, but are consistent with price-taking. Initial conditions can have a permanent effect—including convergence to a Pareto-dominated, stable equilibrium—under conditions that we show are plausible in this setting. Changing the fine from a fixed amount to a fraction of equilibrium prices increases the likelihood of reaching a Pareto-efficient equilibrium without increasing the equilibrium fine collected.

Suggested Citation

  • Florian Scheuer & Kent Smetters, 2018. "How Initial Conditions Can Have Permanent Effects: The Case of the Affordable Care Act," American Economic Journal: Economic Policy, American Economic Association, vol. 10(4), pages 302-343, November.
    • Handle: RePEc:aea:aejpol:v:10:y:2018:i:4:p:302-43
    Note: DOI: 10.1257/pol.20140204
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    Citations

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    Cited by:

    1. Matthew Panhans, 2019. "Adverse Selection in ACA Exchange Markets: Evidence from Colorado," American Economic Journal: Applied Economics, American Economic Association, vol. 11(2), pages 1-36, April.
    2. Dosis, Anastasios, 2022. "Price caps and efficiency in markets with adverse selection," Journal of Mathematical Economics, Elsevier, vol. 99(C).

    More about this item

    JEL classification:

    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
    • H75 - Public Economics - - State and Local Government; Intergovernmental Relations - - - State and Local Government: Health, Education, and Welfare
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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