To design premium subsidies in a health insurance market it is necessary to estimate consumer demand, cost, and study how different subsidy schemes affect insurer's incentives. I combine data on household-level enrollment and plan-level claims from the California Affordable Care Act insurance exchange with a model of insurance demand and insurers' competition to assess equilibrium outcomes under alternative subsidy designs. I estimate that younger households are significantly more price sensitive and cheaper to cover.
H51: National Government Expenditures and Health
We study age-rating restrictions in the health insurance marketplaces introduced by the Affordable Care Act. Although age-rating restrictions affect pre-subsidy premiums, participation is primarily driven by subsidy generosity rather than pricing decisions because most buyers are subsidized. By combining pre- and post-reform data on prices and enrollment, we find that age-rating restrictions alter pre-subsidy premiums, with an increase of $230 per year for buyers under 50 years old and a decrease of $900 per year for buyers over 50.
The effects of the Supplemental Nutrition Assistance Program (SNAP) on obesity have been the focus of much debate. However, causal interpretation of estimates from previous studies, comparing participants to non-participants, is complicated by endogeneity and possible misreporting of participation in SNAP. In this paper, we take a novel approach to examine quasiexperimental variation in SNAP benefit amount on adult obesity. Children of SNAP households qualify for free in-school meals, thus freeing some additional benefits for the household.
Using novel data describing the healthfulness of household food purchases and the retail landscapes consumers face, we measure the role of access in explaining why wealthier and more educated households purchase healthier foods. We find that spatial differences in access, though significant, are small relative to spatial differences in the nutritional content of sales. Socioeconomic disparities in nutritional consumption exist even among households with equivalent access, and the healthfulness of household consumption responds minimally to improvements in local retain environments.