Medicare Part D: Are Insurers Gaming the Low Income Subsidy Design?
- (pp. 1547-80)
AbstractThis paper shows how in Medicare Part D insurers' gaming of the subsidy paid to low-income enrollees distorts premiums and raises the program cost. Using plan-level data from the first five years of the program, I find multiple instances of pricing strategy distortions for the largest insurers. Instrumental variable estimates indicate that the changes in a concentration index measuring the manipulability of the subsidy can explain a large share of the premium growth observed between 2006 and 2011. Removing this distortion could reduce the cost of the program without worsening consumer welfare. (JEL G22, H51, I13, I18)
CitationDecarolis, Francesco. 2015. "Medicare Part D: Are Insurers Gaming the Low Income Subsidy Design?" American Economic Review, 105 (4): 1547-80. DOI: 10.1257/aer.20130903
- G22 Insurance; Insurance Companies; Actuarial Studies
- H51 National Government Expenditures and Health
- I13 Health Insurance, Public and Private
- I18 Health: Government Policy; Regulation; Public Health