Did the individual mandate work?

A paper by Lurie et al. (2021) provides the answer. They reach four conclusions from their analysis: First, the actual penalty paid per uninsured month is less than half the statutory amount. Second, nonetheless, we find visually clear and statistically significant responses to both extensive margin exposure to the mandate and to marginal increases in…

Will health plan outreach increase take-up by enrollees that are healthier or sicker?

Why don’t people eligible for health insurance exchange plans (i.e., Obamacare plans) enroll? One reason could be that they value the health insurance benefit at less than the cost. Another reason could be behavioral frictions; informational search costs and psychological frictions are costly and may preclude enrollment even when benefits are more than cost. For…

Did ACA dent the cost curve?

Clearly, causality is difficult to determine here as we can’t have a counterfactual world with no ACA. At the same time, a paper by Buntin and Graves (2020) makes the case the suggestive evidence indicates that the answer is ‘yes’. …[health] expenditures now account for 17.7 percent of the nation’s gross domestic product, compared to…

Physician perceptions of the ACA

What do physicians thing about the ACA? How have these opinions changed over time? These are the questions that a paper by Riordan et al. (2019) in Health Affairs. The authors surveyed physiicans in both 2012 and 2017 and found that the share of physicians who thought the ACA was good for health care increased…

Medicaid expansion and prescription drug use

How did Medicaid expansion affect prescription drug use? At first glance, one would think that prescriptions increased; more insurance lowers patient out-of-pocket cost so we would expect more prescriptions. Medicaid insurance may crowd out other forms of insurance; if those other forms of insurance covered more drugs, then perhaps utilization would go down. A study…

The end of Obamacare?

As reported in NPR: A federal judge in Texas issued a ruling Friday declaring the Affordable Care Act unconstitutional, apparently setting the stage for another hearing on the health care law by the U.S. Supreme Court. The ruling by U.S. District Judge Reed O’Connor invalidates what’s commonly referred to as Obamacare nationwide, and casts into…

Positive externalities of Medicaid expansion

From Sen and DeLeire (2018): …premiums of Marketplace plans are 11% lower in Medicaid expansion states, controlling for demographic and health characteristics as well as measures of health care access. These results are consistent with evidence on the composition of the private insurance risk pool in expansion versus nonexpansion states and associated differences in expected…

Obamacare premiums rose 32% in 2018

Between 2017 and 2018, premiums Obamacare health insurance plans plans rose by 32%.  To be more specific, the Urban Institute reports that: The national average increase was 32.0 percent for the lowest-priced silver plans and 19.1 percent for gold plans, but the increases varied by states…State changes in average lowest-priced silver premiums ranged from a 22.5…