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Life Cycle Responses to Health Insurance Status

Author

Listed:
  • Florian PELGRIN

    (EDHEC Business School)

  • Pascal ST-AMOUR

    (University of Lausanne and Swiss Finance Institute)

Abstract

Health insurance status can change over the life cycle for exogenous reasons (e.g. Medicare for the elders, PPACA for younger agents, termination of coverage at retirement in employer-provided plans). Durability of the health capital, endogenous mortality and morbidity, as well as backward induction suggests that these changes should affect the dynamic life cycle beyond the period at which they occur. The purpose of this paper is to study these lifetime effects on the optimal allocation (consumption, leisure, health expenditures), status (health, wealth and survival rates), and welfare. We analyse the impact of young (resp. old) insurance status conditional on old (resp. young) coverage through the structural estimation of a dynamic model with endogenous death and sickness risks. Our results show that young insurees are healthier, wealthier, consume more health care yet are less exposed to OOP risks, and substitute less (more) leisure before (after) retirement. Old insurees show similar patterns, except for lower precautionary wealth balances. Compulsory health insurance is unambiguously optimal for elders, and for young agents, except early in the life cycle. We draw other implications for public policy such as Medicare and PPACA.

Suggested Citation

  • Florian PELGRIN & Pascal ST-AMOUR, 2014. "Life Cycle Responses to Health Insurance Status," Swiss Finance Institute Research Paper Series 14-31, Swiss Finance Institute, revised Jun 2015.
    • Handle: RePEc:chf:rpseri:rp1431
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    2. Cristian Pardo & Jorge Sabat, 2025. "Equity and efficiency effects of flat premiums," International Journal of Health Economics and Management, Springer, vol. 25(1), pages 27-49, March.
    3. Eric French & John Bailey Jones, 2017. "Health, Health Insurance, and Retirement: A Survey," Annual Review of Economics, Annual Reviews, vol. 9(1), pages 383-409, September.
    4. Aline de Souza & Mônica Viegas Andrade & Kenya Valéria Micaela de Souza Noronha & Igor Viveiros Melo Souza, 2025. "Effect of age‐related premium readjustment on health insurance cancellation in Brazil: Regression discontinuity approach," Health Economics, John Wiley & Sons, Ltd., vol. 34(1), pages 3-17, January.
    5. Mladenovic, Svetlana Sokolov & Milovancevic, Milos & Mladenovic, Igor & Petrovic, Jelena & Milovanovic, Dragan & Petković, Biljana & Resic, Sead & Barjaktarović, Miljana, 2020. "Identification of the important variables for prediction of individual medical costs billed by health insurance," Technology in Society, Elsevier, vol. 62(C).
    6. Ólafsdóttir, Thorhildur & Ásgeirsdóttir, Tinna Laufey & Norton, Edward C., 2020. "Valuing pain using the subjective well-being method," Economics & Human Biology, Elsevier, vol. 37(C).
    7. Bolin, Kristian & Caputo, Michael R., 2020. "Consumption and investment demand when health evolves stochastically," Journal of Economic Dynamics and Control, Elsevier, vol. 114(C).
    8. Chen, Chang-Chih & Chang, Chia-Chien & Sun, Edward W. & Yu, Min-Teh, 2022. "Optimal decision of dynamic wealth allocation with life insurance for mitigating health risk under market incompleteness," European Journal of Operational Research, Elsevier, vol. 300(2), pages 727-742.
    9. Marlon Azinovic & Luca Gaegauf & Simon Scheidegger, 2022. "Deep Equilibrium Nets," International Economic Review, Department of Economics, University of Pennsylvania and Osaka University Institute of Social and Economic Research Association, vol. 63(4), pages 1471-1525, November.
    10. Chaoran Chen & Zhigang Feng & Jiaying Gu, 2025. "Health, Health Insurance, And Inequality," International Economic Review, Department of Economics, University of Pennsylvania and Osaka University Institute of Social and Economic Research Association, vol. 66(1), pages 107-141, February.
    11. Raquel Fonseca & Pierre-Carl Michaud & Titus Galama & Arie Kapteyn, 2021. "Accounting for the Rise of Health Spending and Longevity," Journal of the European Economic Association, European Economic Association, vol. 19(1), pages 536-579.
    12. Richard Blundell & Jack Britton & Monica Costa Dias & Eric French, 2023. "The Impact of Health on Labor Supply near Retirement," Journal of Human Resources, University of Wisconsin Press, vol. 58(1), pages 282-334.
    13. Li, Chao & Cang, Han & Zhu, Qixuan, 2025. "Health-behavior link: The impact of health shocks on asset allocation and consumption in older households," Economic Analysis and Policy, Elsevier, vol. 86(C), pages 1244-1260.
    14. Julien Hugonnier & Florian Pelgrin & Pascal St‐Amour, 2020. "Closing down the shop: Optimal health and wealth dynamics near the end of life," Health Economics, John Wiley & Sons, Ltd., vol. 29(2), pages 138-153, February.
    15. Blundell, R. & French, E. & Tetlow, G., 2016. "Retirement Incentives and Labor Supply," Handbook of the Economics of Population Aging, in: Piggott, John & Woodland, Alan (ed.), Handbook of the Economics of Population Aging, edition 1, volume 1, chapter 0, pages 457-566, Elsevier.
    16. Cozzi, Guido & Mantovan, Noemi & Sauer, Robert M., 2024. "How Important Are Mental and Physical Health in Career and Family Choices?," IZA Discussion Papers 17143, Institute of Labor Economics (IZA).
    17. Robert M. Sauer & Noemi Mantovan & Guido Cozzi, 2025. "How Do Mental and Physical Health Influence Career and Family Choices?," CHILD Working Papers Series 122 JEL Classification: C, Centre for Household, Income, Labour and Demographic Economics (CHILD) - CCA.

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    Keywords

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    JEL classification:

    • D91 - Microeconomics - - Micro-Based Behavioral Economics - - - Role and Effects of Psychological, Emotional, Social, and Cognitive Factors on Decision Making
    • G11 - Financial Economics - - General Financial Markets - - - Portfolio Choice; Investment Decisions
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private

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