IDEAS home Printed from https://ideas.repec.org/a/pal/gpprii/v44y2019i2d10.1057_s41288-018-00113-7.html
   My bibliography  Save this article

Effects of long-term care insurance on financial well-being

Author

Listed:
  • Jing Dong

    (IMPAQ International)

  • Fabrice Smieliauskas

    (The University of Chicago)

  • R. Tamara Konetzka

    (The University of Chicago)

Abstract

Although private long-term care insurance (LTCI) is often discussed as a potential solution to the need for long-term care financing in the U.S., there is little empirical evidence on the economic consequences of having LTCI. We use U.S. Health and Retirement Study data to examine how LTCI affects key financial outcomes of insured individuals. Using an instrumental variable approach to account for the endogeneity of LTCI purchase, we find that LTCI leads to consistently positive effects on assets, consistently negative effects on Medicaid and Food Stamp enrolment and parent–child financial transfers, and ambiguous effects on out-of-pocket medical payments. These results suggest that although private LTCI does not entirely protect insured individuals against large medical expenditure, it improves the general financial well-being of insured individuals, potentially by reducing Medicaid-related disincentives to asset accumulation, motivating individuals to save more and reduce intergenerational wealth transfers.

Suggested Citation

  • Jing Dong & Fabrice Smieliauskas & R. Tamara Konetzka, 2019. "Effects of long-term care insurance on financial well-being," The Geneva Papers on Risk and Insurance - Issues and Practice, Palgrave Macmillan;The Geneva Association, vol. 44(2), pages 277-302, April.
    • Handle: RePEc:pal:gpprii:v:44:y:2019:i:2:d:10.1057_s41288-018-00113-7
    DOI: 10.1057/s41288-018-00113-7
    as

    Download full text from publisher

    File URL: http://link.springer.com/10.1057/s41288-018-00113-7
    File Function: Abstract
    Download Restriction: Access to full text is restricted to subscribers.
    File URL: https://libkey.io/10.1057/s41288-018-00113-7?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Jonathan Gruber & Aaron Yelowitz, 1999. "Public Health Insurance and Private Savings," Journal of Political Economy, University of Chicago Press, vol. 107(6), pages 1249-1274, December.
    2. Hubbard, R Glenn & Skinner, Jonathan & Zeldes, Stephen P, 1995. "Precautionary Saving and Social Insurance," Journal of Political Economy, University of Chicago Press, vol. 103(2), pages 360-399, April.
    3. Terza, Joseph V. & Basu, Anirban & Rathouz, Paul J., 2008. "Two-stage residual inclusion estimation: Addressing endogeneity in health econometric modeling," Journal of Health Economics, Elsevier, vol. 27(3), pages 531-543, May.
    4. Brown, Jeffrey R. & Finkelstein, Amy, 2007. "Why is the market for long-term care insurance so small?," Journal of Public Economics, Elsevier, vol. 91(10), pages 1967-1991, November.
    5. Mariacristina De Nardi & Eric French & John B. Jones, 2010. "Why Do the Elderly Save? The Role of Medical Expenses," Journal of Political Economy, University of Chicago Press, vol. 118(1), pages 39-75, February.
    6. Congressional Budget Office, 2013. "Rising Demand for Long-Term Services and Supports for Elderly People," Reports 44363, Congressional Budget Office.
    7. Jeffrey R. Brown & Amy Finkelstein, 2008. "The Interaction of Public and Private Insurance: Medicaid and the Long-Term Care Insurance Market," American Economic Review, American Economic Association, vol. 98(3), pages 1083-1102, June.
    8. Norma B. Coe & Gopi Shah Goda & Courtney Harold Van Houtven, 2015. "Family Spillovers of Long-Term Care Insurance," NBER Working Papers 21483, National Bureau of Economic Research, Inc.
    9. William F. Bassett, 2007. "Medicaid's Nursing Home Coverage and Asset Transfers," Public Finance Review, , vol. 35(3), pages 414-439, May.
    10. Imbens, Guido W & Angrist, Joshua D, 1994. "Identification and Estimation of Local Average Treatment Effects," Econometrica, Econometric Society, vol. 62(2), pages 467-475, March.
    11. Mark V. Pauly & Thomas G. Mcguire & Pedro P. Barros (ed.), 2011. "Handbook of Health Economics," Handbook of Health Economics, Elsevier, volume 2, number 2.
    12. Amy Finkelstein & Kathleen McGarry, 2006. "Multiple Dimensions of Private Information: Evidence from the Long-Term Care Insurance Market," American Economic Review, American Economic Association, vol. 96(4), pages 938-958, September.
    13. Goda, Gopi Shah, 2011. "The impact of state tax subsidies for private long-term care insurance on coverage and Medicaid expenditures," Journal of Public Economics, Elsevier, vol. 95(7-8), pages 744-757, August.
    14. Edward C. Norton & Courtney Harold Van Houtven, 2006. "Inter-vivos Transfers and Exchange," Southern Economic Journal, John Wiley & Sons, vol. 73(1), pages 157-172, July.
    15. Karen A. Kopecky & Tatyana Koreshkova, 2014. "The Impact of Medical and Nursing Home Expenses on Savings," American Economic Journal: Macroeconomics, American Economic Association, vol. 6(3), pages 29-72, July.
    16. Zeckhauser, Richard, 1970. "Medical insurance: A case study of the tradeoff between risk spreading and appropriate incentives," Journal of Economic Theory, Elsevier, vol. 2(1), pages 10-26, March.
    17. Pauly, Mark V, 1990. "The Rational Nonpurchase of Long-term-Care Insurance," Journal of Political Economy, University of Chicago Press, vol. 98(1), pages 153-168, February.
    18. Nadia Greenhalgh-Stanley, 2015. "Are the Elderly Responsive in Their Savings Behavior to Changes in Asset Limits for Medicaid?," Public Finance Review, , vol. 43(3), pages 324-346, May.
    19. Congressional Budget Office, 2013. "Rising Demand for Long-Term Services and Supports for Elderly People," Reports 44363, Congressional Budget Office.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Kim, Hoolda & Mitra, Sophie, 2022. "The Economic and Health Effects of Long-Term Care Insurance: New Evidence from Korea," The Journal of the Economics of Ageing, Elsevier, vol. 23(C).
    2. Christophe Courbage & Guillem Montoliu-Montes & Joël Wagner, 2023. "On children’s motives to influence parents’ long-term care insurance purchase: evidence from Switzerland," The Geneva Papers on Risk and Insurance - Issues and Practice, Palgrave Macmillan;The Geneva Association, vol. 48(1), pages 102-129, January.
    3. Ifra Bashir & Ishtiaq Hussain Qureshi, 2023. "A Systematic Literature Review on Personal Financial Well-Being: The Link to Key Sustainable Development Goals 2030," FIIB Business Review, , vol. 12(1), pages 31-48, March.
    4. Mahendru, Mandeep & Sharma, Gagan Deep & Pereira, Vijay & Gupta, Mansi & Mundi, Hardeep Singh, 2022. "Is it all about money honey? Analyzing and mapping financial well-being research and identifying future research agenda," Journal of Business Research, Elsevier, vol. 150(C), pages 417-436.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Amitabh Chandra & Courtney Coile & Corina Mommaerts, 2023. "What Can Economics Say about Alzheimer's Disease?," Journal of Economic Literature, American Economic Association, vol. 61(2), pages 428-470, June.
    2. Coe, Norma B. & Skira, Meghan M. & Van Houtven, Courtney Harold, 2015. "Long-term care insurance: Does experience matter?," Journal of Health Economics, Elsevier, vol. 40(C), pages 122-131.
    3. John Laitner & Dan Silverman & Dmitriy Stolyarov, 2018. "The Role of Annuitized Wealth in Post-retirement Behavior," American Economic Journal: Macroeconomics, American Economic Association, vol. 10(3), pages 71-117, July.
    4. Lambregts, Timo R. & Schut, Frederik T., 2020. "Displaced, disliked and misunderstood: A systematic review of the reasons for low uptake of long-term care insurance and life annuities," The Journal of the Economics of Ageing, Elsevier, vol. 17(C).
    5. Norma B. Coe & Gopi Shah Goda & Courtney Harold Van Houtven, 2015. "Family Spillovers of Long-Term Care Insurance," NBER Working Papers 21483, National Bureau of Economic Research, Inc.
    6. Jeffrey R. Brown & Norma B. Coe & Amy Finkelstein, 2007. "Medicaid Crowd-Out of Private Long-Term Care Insurance Demand: Evidence from the Health and Retirement Survey," NBER Chapters, in: Tax Policy and the Economy, Volume 21, pages 1-34, National Bureau of Economic Research, Inc.
    7. Plisson, Manuel, 2009. "Assurabilité et développement de l'assurance dépendance," Economics Thesis from University Paris Dauphine, Paris Dauphine University, number 123456789/5064 edited by Lorenzi, Jean-Hervé.
    8. Lee M. Lockwood, 2018. "Incidental Bequests and the Choice to Self-Insure Late-Life Risks," American Economic Review, American Economic Association, vol. 108(9), pages 2513-2550, September.
    9. Sergi Jiménez‐Martín & José M. Labeaga‐Azcona & Cristina Vilaplana‐Prieto, 2016. "Interactions between Private Health and Long‐term Care Insurance and the Effects of the Crisis: Evidence for Spain," Health Economics, John Wiley & Sons, Ltd., vol. 25(S2), pages 159-179, November.
    10. Joan Costa-i-Font & Nilesh Raut, 2021. "Long-Term Care Partnership Effects on Medicaid and Private Insurance," CESifo Working Paper Series 9335, CESifo.
    11. Coe, Norma B. & Goda, Gopi Shah & Van Houtven, Courtney Harold, 2023. "Family spillovers and long-term care insurance," Journal of Health Economics, Elsevier, vol. 90(C).
    12. Eric French & John Bailey Jones & Elaine Kelly & Jeremy McCauley, 2018. "End-of-Life Medical Expenses," Working Paper 18-18, Federal Reserve Bank of Richmond.
    13. Martin Eling & Omid Ghavibazoo, 2019. "Research on long-term care insurance: status quo and directions for future research," The Geneva Papers on Risk and Insurance - Issues and Practice, Palgrave Macmillan;The Geneva Association, vol. 44(2), pages 303-356, April.
    14. Ameriks, John & Briggs, Joseph & Caplin, Andrew & Shapiro, Matthew D. & Tonetti, Christopher, 2016. "Late-in-Life Risks and the Under-Insurance Puzzle," Research Papers 3485, Stanford University, Graduate School of Business.
    15. Jeffrey R. Brown & Amy Finkelstein, 2009. "The Private Market for Long‐Term Care Insurance in the United States: A Review of the Evidence," Journal of Risk & Insurance, The American Risk and Insurance Association, vol. 76(1), pages 5-29, March.
    16. John Ameriks & Joseph Briggs & Andrew Caplin & Matthew D. Shapiro & Christopher Tonetti, 2016. "The Long-Term-Care Insurance Puzzle: Modeling and Measurement," NBER Working Papers 22726, National Bureau of Economic Research, Inc.
    17. R. Tamara Konetzka & Daifeng He & Jing Dong & John A. Nyman, 2019. "Moral hazard and long-term care insurance," The Geneva Papers on Risk and Insurance - Issues and Practice, Palgrave Macmillan;The Geneva Association, vol. 44(2), pages 231-251, April.
    18. Max Groneck, 2017. "Bequests and Informal Long-Term Care: Evidence from HRS Exit Interviews," Journal of Human Resources, University of Wisconsin Press, vol. 52(2), pages 531-572.
    19. Haizhen Lin & Jeffrey T. Prince, 2012. "The Impact of the Partnership Long-term Care Insurance Program on Private Coverage and Medicaid Expenditures," Working Papers 2012-01, Indiana University, Kelley School of Business, Department of Business Economics and Public Policy.
    20. M. Martin Boyer & Philippe De Donder & Claude Denys Fluet & Marie-Louise Leroux & Pierre-Carl Michaud, 2018. "A Canadian Parlor Room-Type Approach to the Long-Term Care Insurance Puzzle," CIRANO Working Papers 2018s-13, CIRANO.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:pal:gpprii:v:44:y:2019:i:2:d:10.1057_s41288-018-00113-7. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Sonal Shukla or Springer Nature Abstracting and Indexing (email available below). General contact details of provider: http://www.palgrave-journals.com/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.