IDEAS home Printed from https://ideas.repec.org/p/nbr/nberwo/14692.html
   My bibliography  Save this paper

Take-Up of Medicare Part D: Results from the Health and Retirement Study

Author

Listed:
  • Helen Levy
  • David Weir

Abstract

We analyze data from the Health and Retirement Study on senior citizens' take-up of Medicare Part D. Take-up among those without drug coverage in 2004 was high; about fifty to sixty percent of this group have Part D coverage in 2006. Only seven percent of senior citizens lack drug coverage in 2006 compared with 24 percent in 2004. We find little circumstantial evidence that Part D crowded out private coverage in the short run, since the persistence of employer coverage was only slightly lower in 2004 -- 2006 than it was in 2002 -- 2004. We find that demand for prescription drugs is the most important determinant of the decision to enroll in Part D among those with no prior coverage. Many of those who remained without coverage in 2006 reported that they do not use prescribed medicines, and the majority had relatively low out-of-pocket spending. Thus, for the most part, Medicare beneficiaries seem to have been able to make economically rational decisions about Part D enrollment despite the complexity of the program. We also find that Part D erased socioeconomic gradients in drug coverage among the elderly.

Suggested Citation

  • Helen Levy & David Weir, 2009. "Take-Up of Medicare Part D: Results from the Health and Retirement Study," NBER Working Papers 14692, National Bureau of Economic Research, Inc.
  • Handle: RePEc:nbr:nberwo:14692
    Note: EH PE
    as

    Download full text from publisher

    File URL: http://www.nber.org/papers/w14692.pdf
    Download Restriction: no
    ---><---

    Other versions of this item:

    References listed on IDEAS

    as
    1. repec:mpr:mprres:3849 is not listed on IDEAS
    2. Todd E. Elder & Elizabeth T. Powers, 2004. "SSI for the Aged and the Problem of 'Take-Up'," Working Papers wp076, University of Michigan, Michigan Retirement Research Center.
    3. Kathleen McGarry, 1996. "Factors Determining Participation of the Elderly in Supplemental Security Income," Journal of Human Resources, University of Wisconsin Press, vol. 31(2), pages 331-358.
    4. Blundell, Richard & Fry, Vanessa & Walker, Ian, 1987. "Modelling the Take-up of Means-tested Benefits: the Case of Housing Benefits in the United Kingdom," Economic Journal, Royal Economic Society, vol. 98(390), pages 58-74, Supplemen.
    5. Moffitt, Robert, 1983. "An Economic Model of Welfare Stigma," American Economic Review, American Economic Association, vol. 73(5), pages 1023-1035, December.
    6. Mark Duggan & Patrick Healy & Fiona Scott Morton, 2008. "Providing Prescription Drug Coverage to the Elderly: America's Experiment with Medicare Part D," Journal of Economic Perspectives, American Economic Association, vol. 22(4), pages 69-92, Fall.
    7. Heiss, Florian & McFadden, Daniel L. & Winter, Joachim, 2006. "Who failed to enroll in Medicare Part D, and why? Early results," Munich Reprints in Economics 19427, University of Munich, Department of Economics.
    8. Town, Robert & Liu, Su, 2003. "The Welfare Impact of Medicare HMOs," RAND Journal of Economics, The RAND Corporation, vol. 34(4), pages 719-736, Winter.
    9. Todd Elder & Elizabeth Powers, 2006. "Public Health Insurance and SSI Program Participation Among the Aged," Working Papers wp117, University of Michigan, Michigan Retirement Research Center.
    10. John A. List, 2002. "Preference Reversals of a Different Kind: The "More Is Less" Phenomenon," American Economic Review, American Economic Association, vol. 92(5), pages 1636-1643, December.
    11. Florian Heiss & Daniel McFadden & Joachim Winter, 2010. "Mind the Gap! Consumer Perceptions and Choices of Medicare Part D Prescription Drug Plans," NBER Chapters, in: Research Findings in the Economics of Aging, pages 413-481, National Bureau of Economic Research, Inc.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Carey, Colleen, 2021. "Sharing the burden of subsidization: Evidence on pass-through from a subsidy revision in Medicare Part D," Journal of Public Economics, Elsevier, vol. 198(C).
    2. Gary V. Engelhardt & Jonathan Gruber, 2010. "Medicare Part D and the Financial Protection of the Elderly," NBER Working Papers 16155, National Bureau of Economic Research, Inc.
    3. Jonathan Gruber & Helen Levy, 2009. "The Evolution of Medical Spending Risk," Journal of Economic Perspectives, American Economic Association, vol. 23(4), pages 25-48, Fall.
    4. Heiss, Florian & Leive, Adam & McFadden, Daniel & Winter, Joachim, 2013. "Plan selection in Medicare Part D: Evidence from administrative data," Journal of Health Economics, Elsevier, vol. 32(6), pages 1325-1344.
    5. Vetter, Stefan & Heiss, Florian & McFadden, Daniel & Winter, Joachim, 2013. "Risk attitudes and Medicare Part D enrollment decisions," Economics Letters, Elsevier, vol. 119(2), pages 128-132.
    6. Helen Levy, 2020. "The Risk of High Out-of-Pocket Health Spending among Older Americans," Working Papers wp409, University of Michigan, Michigan Retirement Research Center.
    7. Padmaja Ayyagari & Daifeng He, 2017. "The Role of Medical Expenditure Risk in Portfolio Allocation Decisions," Health Economics, John Wiley & Sons, Ltd., vol. 26(11), pages 1447-1458, November.
    8. William Encinosa, 2009. "Value-based insurance design in medicare," Applied Health Economics and Health Policy, Springer, vol. 7(3), pages 149-154, September.
    9. Alpert, Abby, 2016. "The anticipatory effects of Medicare Part D on drug utilization," Journal of Health Economics, Elsevier, vol. 49(C), pages 28-45.
    10. Moulton, Stephanie & Rhodes, Alec & Haurin, Donald & Loibl, Cäzilia, 2022. "Managing the onset of a new disease in older age: Housing wealth, mortgage borrowing, and medication adherence," Social Science & Medicine, Elsevier, vol. 314(C).
    11. Keane, Michael & Ketcham, Jonathan & Kuminoff, Nicolai & Neal, Timothy, 2021. "Evaluating consumers’ choices of Medicare Part D plans: A study in behavioral welfare economics," Journal of Econometrics, Elsevier, vol. 222(1), pages 107-140.
    12. Pak, Tae-Young & Kim, GwanSeon, 2017. "The impact of Medicare Part D on cognitive functioning at older ages," Social Science & Medicine, Elsevier, vol. 193(C), pages 118-126.
    13. Thomas C. Buchmueller & Kyle Grazier & Richard A. Hirth & Edward N. Okeke, 2013. "The Price Sensitivity Of Medicare Beneficiaries: A Regression Discontinuity Approach," Health Economics, John Wiley & Sons, Ltd., vol. 22(1), pages 35-51, January.
    14. Robert Kaestner & Cuping Schiman & G. Caleb Alexander, 2019. "Effects of Prescription Drug Insurance on Hospitalization and Mortality: Evidence from Medicare Part D," Journal of Risk & Insurance, The American Risk and Insurance Association, vol. 86(3), pages 595-628, September.
    15. Elham Mahmoudi & Helen G. Levy, 2016. "How Did Medicare Part D Affect Racial and Ethnic Disparities in Drug Coverage?," Journals of Gerontology: Series B, Gerontological Society of America, vol. 71(3), pages 581-589.
    16. Gary V. Engelhardt & Jonathan Gruber, 2009. "Medicare Part D and the Financial Protection of the Elderly," Working Papers, Center for Retirement Research at Boston College wp2009-24, Center for Retirement Research, revised Oct 2009.
    17. Dan Shane; & Pravin Trivedi;, 2012. "What Drives Differences in Health Care Demand? The Role of Health Insurance and Selection Bias," Health, Econometrics and Data Group (HEDG) Working Papers 12/09, HEDG, c/o Department of Economics, University of York.
    18. Florian Heiss & Daniel McFadden & Joachim Winter, 2009. "Regulation of private health insurance markets: Lessons from enrollment, plan type choice, and adverse selection in Medicare Part D," NBER Working Papers 15392, National Bureau of Economic Research, Inc.
    19. Padmaja Ayyagari & Dan M. Shane & George L. Wehby, 2017. "The Impact of Medicare Part D on Emergency Department Visits," Health Economics, John Wiley & Sons, Ltd., vol. 26(4), pages 536-544, April.
    20. Padmaja Ayyagari, 2016. "Prescription drug coverage and chronic pain," International Journal of Health Economics and Management, Springer, vol. 16(2), pages 189-200, June.
    21. Robert Kaestner & Nasreen Khan, 2010. "Medicare Part D and its Effect on the Use of Prescription Drugs, Use of Other Health Care Services and Health of the Elderly," NBER Working Papers 16011, National Bureau of Economic Research, Inc.
    22. Ayyagari, Padmaja & Shane, Dan M., 2015. "Does prescription drug coverage improve mental health? Evidence from Medicare Part D," Journal of Health Economics, Elsevier, vol. 41(C), pages 46-58.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Helen Levy & David Weir, 2007. "Take-Up of Medicare Part D and the SSA Subsidy: Early Results from the Health and Retirement Study," Working Papers wp163, University of Michigan, Michigan Retirement Research Center.
    2. Vetter, Stefan & Heiss, Florian & McFadden, Daniel & Winter, Joachim, 2013. "Risk attitudes and Medicare Part D enrollment decisions," Economics Letters, Elsevier, vol. 119(2), pages 128-132.
    3. Francesco Decarolis & Maria Polyakova & Stephen P. Ryan, 2020. "Subsidy Design in Privately Provided Social Insurance: Lessons from Medicare Part D," Journal of Political Economy, University of Chicago Press, vol. 128(5), pages 1712-1752.
    4. Claudio Lucarelli & Jeffrey Prince & Kosali Simon, 2012. "The Welfare Impact Of Reducing Choice In Medicare Part D: A Comparison Of Two Regulation Strategies," International Economic Review, Department of Economics, University of Pennsylvania and Osaka University Institute of Social and Economic Research Association, vol. 53(4), pages 1155-1177, November.
    5. Jonathan D. Ketcham & Claudio Lucarelli & Eugenio J. Miravete & M. Christopher Roebuck, 2012. "Sinking, Swimming, or Learning to Swim in Medicare Part D," American Economic Review, American Economic Association, vol. 102(6), pages 2639-2673, October.
    6. Dahlia K. Remler & Jason E. Rachlin & Sherry A. Glied, 2001. "What can the take-up of other programs teach us about how to improve take-up of health insurance programs?," NBER Working Papers 8185, National Bureau of Economic Research, Inc.
    7. Florian Heiss & Daniel McFadden & Joachim Winter, 2009. "Regulation of private health insurance markets: Lessons from enrollment, plan type choice, and adverse selection in Medicare Part D," NBER Working Papers 15392, National Bureau of Economic Research, Inc.
    8. Kesternich, Iris & Heiss, Florian & McFadden, Daniel & Winter, Joachim, 2013. "Suit the action to the word, the word to the action: Hypothetical choices and real decisions in Medicare Part D," Journal of Health Economics, Elsevier, vol. 32(6), pages 1313-1324.
    9. David Coady & César Martinelli & Susan W. Parker, 2013. "Information and Participation in Social Programs," The World Bank Economic Review, World Bank Group, vol. 27(1), pages 149-170.
    10. Momi Dahan & Udi Nisan, 2010. "The effect of benefits level on take-up rates: evidence from a natural experiment," International Tax and Public Finance, Springer;International Institute of Public Finance, vol. 17(2), pages 151-173, April.
    11. Keith M. Marzilli Ericson, 2014. "Consumer Inertia and Firm Pricing in the Medicare Part D Prescription Drug Insurance Exchange," American Economic Journal: Economic Policy, American Economic Association, vol. 6(1), pages 38-64, February.
    12. Regina T. Riphahn, 2001. "Rational Poverty or Poor Rationality? The Take‐up of Social Assistance Benefits," Review of Income and Wealth, International Association for Research in Income and Wealth, vol. 47(3), pages 379-398, September.
    13. Daniel McFadden, 2009. "The human side of mechanism design: a tribute to Leo Hurwicz and Jean-Jacque Laffont," Review of Economic Design, Springer;Society for Economic Design, vol. 13(1), pages 77-100, April.
    14. Pellizzari, Michele, 2006. "Unemployment duration and the interactions between unemployment insurance and social assistance," Labour Economics, Elsevier, vol. 13(6), pages 773-798, December.
    15. repec:zbw:rwirep:0117 is not listed on IDEAS
    16. Sylvain Chareyron & Patrick Domingues, 2018. "Take‐Up of Social Assistance Benefits: The Case of the French Homeless," Review of Income and Wealth, International Association for Research in Income and Wealth, vol. 64(1), pages 170-191, March.
    17. Sonja C. Kassenboehmer & John P. Haisken-DeNew, 2009. "Social Jealousy and Stigma: Negative Externalities of Social Assistance Payments in Germany," Ruhr Economic Papers 0117, Rheinisch-Westfälisches Institut für Wirtschaftsforschung, Ruhr-Universität Bochum, Universität Dortmund, Universität Duisburg-Essen.
    18. Heiss, Florian & Leive, Adam & McFadden, Daniel & Winter, Joachim, 2013. "Plan selection in Medicare Part D: Evidence from administrative data," Journal of Health Economics, Elsevier, vol. 32(6), pages 1325-1344.
    19. Bargain, Olivier & Immervoll, Herwig & Viitamäki, Heikki, 2007. "How Tight Are Safety-Nets in Nordic Countries? Evidence from Finnish Register Data," IZA Discussion Papers 3004, Institute of Labor Economics (IZA).
    20. Jason T. Abaluck & Jonathan Gruber, 2009. "Choice Inconsistencies Among the Elderly: Evidence from Plan Choice in the Medicare Part D Program," NBER Working Papers 14759, National Bureau of Economic Research, Inc.
    21. Gary V. Engelhardt & Jonathan Gruber, 2011. "Medicare Part D and the Financial Protection of the Elderly," American Economic Journal: Economic Policy, American Economic Association, vol. 3(4), pages 77-102, November.

    More about this item

    JEL classification:

    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • I38 - Health, Education, and Welfare - - Welfare, Well-Being, and Poverty - - - Government Programs; Provision and Effects of Welfare Programs

    NEP fields

    This paper has been announced in the following NEP Reports:

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:nbr:nberwo:14692. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: the person in charge (email available below). General contact details of provider: https://edirc.repec.org/data/nberrus.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.