Health Policy in 2017 and Beyond
Saturday, Jan. 7, 2017 5:30 PM – 7:15 PM
- Chair: Amanda Ellen Kowalski, Yale University
Regulated Age-Based Pricing in Subsidized Health Insurance Exchanges
AbstractWe analyze the effect of restricted age-rating adjustments in the state-level health insurance marketplaces introduced by the Affordable Care Act (ACA). In these markets the vast majority of buyers are beneficiaries of federal subsidies, and for this group the level of post-subsidy premiums is approximately constant across ages. Consequently, although restricted age-rating adjustments affect insurers’ revenues for any given age-composition of enrollment, such composition is largely determined by the generosity of subsidies rather than by insurers’ pricing decisions. We estimate that the combination of these two regulations substantially raised pre-subsidy premiums for young buyers while reducing pre-subsidy premiums for older adults. At the current level of subsidies older adults represent the majority of enrollees, hence the primary effect of restricted age-rating adjustments was to decrease government spending in subsidies by approximately $2.3 billion per-year. Geographic heterogeneity of the age-composition of the uninsured leads to corresponding heterogeneity in the impact of age-rating restrictions on premiums and subsidy outlays. We discuss possible implications of tailoring the parameters of age-rating regulations to how the age-composition of the uninsured varies across states.
Measuring the Returns of Nurses: Evidence from a Parental Leave Program
AbstractNurses define the largest health profession. In this paper, we measure the return of nurses on health care delivery and patient health outcomes using a natural experiment, which led to a sudden, unintended, and persistent 12% reduction in nurse employment. Our findings indicate detrimental effects on hospital care delivery as indicated by an increase in 30-day readmission rates and a distortion of technology utilization. Our findings for nursing homes are more drastic indicating a 14% increase in nursing home mortality among the elderly aged 85 and older.
- I0 - General