scholarly journals After Midnight: A Regression Discontinuity Design in Length of Postpartum Hospital Stays

2011 ◽  
Vol 3 (3) ◽  
pp. 1-34 ◽  
Author(s):  
Douglas Almond ◽  
Joseph J Doyle

Estimates of moral hazard in health insurance markets can be confounded by adverse selection. This paper considers a plausibly exogenous source of variation in insurance coverage for childbirth in California. We find that additional health insurance coverage induces substantial extensions in length of hospital stay for mother and newborn. However, remaining in the hospital longer has no effect on readmissions or mortality, and the estimates are precise. Our results suggest that for uncomplicated births, minimum insurance mandates incur substantial costs without detectable health benefits. (JEL D82, G22, I12, I18, J13)

2017 ◽  
Vol 31 (4) ◽  
pp. 51-72 ◽  
Author(s):  
Keith Marzilli Ericson ◽  
Justin Sydnor

In most health insurance markets in the United States, consumers have substantial choice about their health insurance plan. However additional choice is not an unmixed blessing as it creates challenges related to both consumer confusion and adverse selection. There is mounting evidence that many people have difficulty understanding the value of insurance coverage, like evaluating the relative benefits of lower premiums versus lower deductibles. Also, in most US health insurance markets, people cannot be charged different prices for insurance based on their individual level of health risk. This creates the potential for well-known problems of adverse selection because people will often base the level of health insurance coverage they choose partly on their health status. In this essay, we examine how the forces of consumer confusion and adverse selection interact with each other and with market institutions to affect how valuable it is to have multiple levels of health insurance coverage available in the market.


2021 ◽  
Vol 40 ◽  
Author(s):  
Joshua D. Frederick ◽  
J. Bradley Karl

With projections of costs in the billions for COVID-19 treatments alone, and heightened scrutiny on COVID-19-related health insurance coverage, the National Association of Insurance Commissioners (NAIC) convened in March 2020 to discuss how the industry could best deal with a pandemic. While the ramifications of the COVID-19 event are in their infant stages, it is important to consider the implications such catastrophic risks have on an insurance market. We evaluate state-level changes presented by the NAIC in response to the COVID-19 pandemic and use prior research to offer insight into health insurance in a post-COVID-19 world. This manuscript aims to provide a summary of the NAIC’s current standing during the pandemic, while presenting insight into policy implications regarding regulation in health insurance markets during catastrophic events.


2018 ◽  
Vol 37 (1) ◽  
pp. 88-105 ◽  
Author(s):  
Genevieve E. O'Connor

The Affordable Care Act (ACA) expands health insurance coverage to millions of Americans. Despite the act having been signed into law more than five years ago, health care affordability in the ACA era remains a topic of empirical inquiry, relevant to academicians and public policy makers. A primary concern, with implications for any future legislation, is whether all consumer groups have equitable access to health insurance options through ACA-mandated health insurance markets (HIMs). Utilizing pricing information and demographic data for states that adopted the Healthcare.gov platform, this study examines relationships between health insurance premiums, competition, and population characteristics. Results indicate that competition within HIMs is multifaceted. Although markets with a large number of insurance plans are associated with lower premiums, this effect is moderated by the concentration of insurers in the market and number of rating areas. Furthermore, population characteristics are related to premiums, where premiums vary by HIM demographics. Findings also suggest that access is less equitable in areas that have not adopted Medicaid expansion plans and areas that serve a large percentage of uninsured consumers.


2020 ◽  
Vol 45 (4) ◽  
pp. 465-483
Author(s):  
Stacey McMorrow ◽  
Linda J. Blumberg ◽  
John Holahan

Abstract The primary goals of the Affordable Care Act (ACA) were to increase the availability and affordability of health insurance coverage and thereby improve access to needed health care services. Numerous studies have overwhelmingly confirmed that the law has reduced uninsurance and improved affordability of coverage and care for millions of Americans. Not everyone believed that the ACA would lead to positive outcomes, however. Critics raised numerous concerns in the years leading up to the law's passage and full implementation, including about its consequences for national health spending, labor supply, employer health insurance markets, provider capacity, and overall population health. This article considers five frequently heard worst-case scenarios related to the ACA and provides research evidence that these fears did not come to pass.


Author(s):  
April Todd-Malmlov ◽  
Alexander Oftelie ◽  
Kathleen Call ◽  
Jeanette Ziegenfuss

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