The Affordable Care Act After a Decade: Industrial Organization of the Insurance Exchanges

IF 6.8 2区 经济学 Q1 ECONOMICS
Benjamin Handel,Jonathan Kolstad
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引用次数: 0

Abstract

The regulated insurance exchanges set up in the Affordable Care Act (ACA) were designed to deliver affordable, efficient health coverage through private insurers. It is crucial to study the complex industrial organization (IO) of these exchanges in order to assess their impacts during the first decade of the ACA and to project their effects going forward. We revisit the inherent market failures in health care markets that necessitate key ACA exchange regulations and investigate whether they have succeeded in their goals of expanding coverage, creating robust marketplaces, providing product variety, and generating innovation in health care delivery. We discuss empirical IO research to date and also highlight shortcomings in the existing research that can be addressed moving forward. We conclude with a discussion of IO research-based policy lessons for the ACA exchanges and, more generally, for managed competition of private insurance in health care. Expected final online publication date for the Annual Review of Economics, Volume 14 is August 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
十年后的平价医疗法案:保险交易所的工业组织
在《平价医疗法案》(ACA)中设立的受监管的保险交易所旨在通过私营保险公司提供负担得起的、高效的医疗保险。研究这些交换的复杂产业组织(IO)是至关重要的,以便评估它们在ACA的第一个十年中的影响,并预测它们未来的影响。我们重新审视医疗保健市场中固有的市场失灵,这些失灵需要ACA关键的交易法规,并调查它们是否成功地实现了扩大覆盖范围、创建强大的市场、提供产品多样性和在医疗保健服务方面产生创新的目标。我们讨论了迄今为止的实证IO研究,并强调了现有研究中可以解决的缺点。最后,我们讨论了基于IO研究的政策教训,为ACA交流,更广泛地说,为管理竞争的私人保险在医疗保健。《经济学年度评论》第14卷的最终在线出版日期预计为2022年8月。修订后的估计数请参阅http://www.annualreviews.org/page/journal/pubdates。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
9.70
自引率
3.60%
发文量
34
期刊介绍: The Annual Review of Economics covers significant developments in the field of economics, including macroeconomics and money; microeconomics, including economic psychology; international economics; public finance; health economics; education; economic growth and technological change; economic development; social economics, including culture, institutions, social interaction, and networks; game theory, political economy, and social choice; and more.
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