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When Should There Be Vertical Choice in Health Insurance Markets?

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  • Victoria R. Marone
  • Adrienne Sabety

Abstract

We study the welfare effects of offering choice over coverage levels—"vertical choice"—in regulated health insurance markets. We emphasize that heterogeneity in efficient coverage level is not sufficient to motivate choice. When premiums cannot reflect individuals' costs, it may not be in consumers' best interest to select their efficient coverage level. We show that vertical choice is efficient only if consumers with higher willingness to pay have a higher efficient level of coverage. We investigate this condition empirically and find that as long as a minimum coverage level can be enforced, the welfare gains from vertical choice are either zero or economically small.

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  • Victoria R. Marone & Adrienne Sabety, 2022. "When Should There Be Vertical Choice in Health Insurance Markets?," American Economic Review, American Economic Association, vol. 112(1), pages 304-342, January.
    • Handle: RePEc:aea:aecrev:v:112:y:2022:i:1:p:304-42
    DOI: 10.1257/aer.20201073
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    References listed on IDEAS

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    1. Jose Apesteguia & Miguel A. Ballester, 2018. "Monotone Stochastic Choice Models: The Case of Risk and Time Preferences," Journal of Political Economy, University of Chicago Press, vol. 126(1), pages 74-106.
    2. David Revelt and Kenneth Train., 2000. "Customer-Specific Taste Parameters and Mixed Logit: Households' Choice of Electricity Supplier," Economics Working Papers E00-274, University of California at Berkeley.
    3. Dubin, Jeffrey A & McFadden, Daniel L, 1984. "An Econometric Analysis of Residential Electric Appliance Holdings and Consumption," Econometrica, Econometric Society, vol. 52(2), pages 345-362, March.
    4. David Revelt & Kenneth Train, 1998. "Mixed Logit With Repeated Choices: Households' Choices Of Appliance Efficiency Level," The Review of Economics and Statistics, MIT Press, vol. 80(4), pages 647-657, November.
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    Cited by:

    1. Marika Cabral & Colleen Carey & Jinyeong Son, 2023. "Partial Outsourcing of Public Programs: Evidence on Determinants of Choice in Medicare," NBER Working Papers 31141, National Bureau of Economic Research, Inc.
    2. Nicholas Tilipman, 2022. "Employer Incentives and Distortions in Health Insurance Design: Implications for Welfare and Costs," American Economic Review, American Economic Association, vol. 112(3), pages 998-1037, March.
    3. Benjamin Handel & Nianyi Hong & Lynn M. Hua & Yuki Ito, 2023. "Employer risk‐adjustment transitions with inertial consumers: Evidence from CalPERS," Journal of Risk & Insurance, The American Risk and Insurance Association, vol. 90(1), pages 93-121, March.
    4. Casey Rothschild, 2024. "Welfare analysis in insurance markets," The Geneva Risk and Insurance Review, Palgrave Macmillan;International Association for the Study of Insurance Economics (The Geneva Association), vol. 49(1), pages 36-58, March.
    5. Anderson, David M. & Hoagland, Alex & Zhu, Ed, 2024. "Medical bill shock and imperfect moral hazard," Journal of Public Economics, Elsevier, vol. 236(C).

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    More about this item

    JEL classification:

    • D82 - Microeconomics - - Information, Knowledge, and Uncertainty - - - Asymmetric and Private Information; Mechanism Design
    • G22 - Financial Economics - - Financial Institutions and Services - - - Insurance; Insurance Companies; Actuarial Studies
    • H75 - Public Economics - - State and Local Government; Intergovernmental Relations - - - State and Local Government: Health, Education, and Welfare
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • I21 - Health, Education, and Welfare - - Education - - - Analysis of Education

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