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Employment and Adverse Selection in Health Insurance.

Jayanta Bhattacharya1, William B Vogt2

  • 1Center for Primary Care and Outcomes Research, Stanford Medical School, 117 Encina Commons, Stanford, CA 94305-6019, USA.

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Summary
This summary is machine-generated.

Employers may offer health insurance to mitigate adverse selection. A new model shows pooling equilibria are more likely with high job-switching costs or non-persistent health status, verified by survey data.

Keywords:
Affordable Care Actadverse selectionemployee benefitshealth insurancemedical spending

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Area of Science:

  • Health economics
  • Labor economics
  • Insurance markets

Background:

  • Adverse selection poses challenges in health insurance markets.
  • Employer-provided health insurance is a significant component of employee compensation.
  • Understanding employee sorting behavior is crucial for insurance provision models.

Purpose of the Study:

  • To develop and test a novel model of employer-provided health insurance.
  • To analyze the impact of adverse selection on insurance provision.
  • To identify factors influencing employee sorting in response to insurance offerings.

Main Methods:

  • Constructed a theoretical model of employer health insurance provision.
  • Incorporated adverse selection and employee health status dynamics.
  • Empirically tested model implications using Current Population Survey data linked with Department of Labor job information.

Main Results:

  • Demonstrated that employers' inability to observe employee health influences insurance provision decisions.
  • Showed that pooling equilibria are more probable when job-switching costs are high.
  • Found that non-persistent health status increases the likelihood of pooling equilibria.

Conclusions:

  • The model provides insights into employer health insurance markets with adverse selection.
  • Employee sorting behavior is significantly influenced by job characteristics and health status.
  • Empirical evidence supports the model's predictions regarding pooling equilibria.