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Genetic Adverse Selection: Evidence from Long-Term Care Insurance and Huntington Disease

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  • Emily Oster
  • Ira Shoulson
  • Kimberly Quaid
  • E. Ray Dorsey

Abstract

Individual, personalized genetic information is increasingly available, leading to the possibility of greater adverse selection over time, particularly in individual-payer insurance markets; this selection could impact the viability of these markets. We use data on individuals at risk for Huntington disease (HD), a degenerative neurological disorder with significant effects on morbidity, to estimate adverse selection in long-term care insurance. We find strong evidence of adverse selection: individuals who carry the HD genetic mutation are up to 5 times as likely as the general population to own long-term care insurance. We use these estimates to make predictions about the future of this market as genetic information increases. We argue that even relatively limited increases in genetic information may threaten the viability of private long-term care insurance.

Suggested Citation

  • Emily Oster & Ira Shoulson & Kimberly Quaid & E. Ray Dorsey, 2009. "Genetic Adverse Selection: Evidence from Long-Term Care Insurance and Huntington Disease," NBER Working Papers 15326, National Bureau of Economic Research, Inc.
  • Handle: RePEc:nbr:nberwo:15326
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    More about this item

    JEL classification:

    • D82 - Microeconomics - - Information, Knowledge, and Uncertainty - - - Asymmetric and Private Information; Mechanism Design
    • 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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