Heterogeneity in crowd‐out by risk aversion: Assessing the effect of the ACA Medicaid expansion

IF 1.1 Q3 BUSINESS, FINANCE
Sezen O. Onal
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引用次数: 0

Abstract

In this study, I estimate the heterogeneity in the crowd‐out of private health insurance by risk aversion with the Medicaid expansion under the Affordable Care Act. Using data from the Health and Retirement Study, I find that the Medicaid expansion led to a decrease in private coverage among risk‐loving individuals by 5 percentage points. However, the expansion did not lead to any meaningful change in private coverage for risk‐averse individuals. This finding suggests that risk‐averse individuals are willing to keep their private coverage, even though they become eligible for Medicaid. This potentially signals a sorting effect into private insurance. Under the assumption that highly risk‐averse individuals typically display superior health conditions, this preferential behavior could signify a form of advantageous selection into private insurance. Furthermore, the expansion increased Medicaid coverage by 3.4 percentage points for risk‐loving individuals, while not causing any discernible change in coverage among risk‐averse individuals. Such differential responses could potentially influence the risk composition of Medicaid coverage, and subsequently impact the cumulative expenditure associated with it.
风险规避挤出的异质性:评估《美国医疗补助法案》(ACA)医疗补助扩展的效果
在本研究中,我估算了《平价医疗法案》扩大医疗补助计划后,风险规避对私人医疗保险挤出的异质性。利用《健康与退休研究》(Health and Retirement Study)的数据,我发现《医疗补助计划》(Medicaid)的扩大导致风险偏好者的私人保险减少了 5 个百分点。然而,对于规避风险的个人来说,医疗补助的扩大并没有导致私人保险发生任何有意义的变化。这一发现表明,规避风险的个人愿意保留他们的私人保险,即使他们有资格获得《医疗补助计划》。这可能预示着私人保险的分类效应。根据高风险规避者通常表现出优越的健康状况这一假设,这种偏好行为可能意味着对私人保险的一种有利选择。此外,医疗补助计划的扩大使风险偏好者的覆盖率提高了 3.4 个百分点,而风险规避者的覆盖率却没有明显变化。这种不同的反应可能会影响《医疗补助计划》的风险构成,进而影响与之相关的累计支出。
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来源期刊
Risk Management and Insurance Review
Risk Management and Insurance Review Economics, Econometrics and Finance-Finance
CiteScore
1.90
自引率
0.00%
发文量
28
期刊介绍: Risk Management and Insurance Review publishes respected, accessible, and high-quality applied research, and well-reasoned opinion and discussion in the field of risk and insurance. The Review"s "Feature Articles" section includes original research involving applications and applied techniques. The "Perspectives" section contains articles providing new insights on the research literature, business practice, and public policy. The "Educational Insights" section provides a repository of high-caliber model lectures in risk and insurance, along with articles discussing and evaluating instructional techniques.
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