I take advantage of regulatory and pricing dynamics in Medicare Part D to empirically explore interactions among adverse selection, switching costs, and regulation. I first document novel evidence of adverse selection and switching costs within Part D using detailed administrative data. I then...

Die Pflegeversicherung steht unter finanziellem Druck: In den vergangenen Jahren wurden die Leistungen durch mehrere Reformen erheblich ausgeweitet. Die Leistungsausweitung zeigte sowohl bei der sozialen als auch bei der privaten Pflegeversicherung Folgen. Bei der sozialen Pflegeversicherung war...

We document that political frictions significantly affect both pricing and supply in the long-term care insurance (LTCI) market. Comparing insurers' requests for premium increases submitted in the same year and for the same policy to different state regulators, we find that they are 7.7% more...

Conventional wisdom suggests that if private health insurance plans compete alongside a public option, they may endanger the latter's financial stability by cream-skimming good risks. Documenting cream-skimming in dual insurance systems empirically is challenging, since selection into private...

To combat adverse selection, governments increasingly base payments to health plans and providers on enrollees' scores from risk-adjustment formulae. In 2004, Medicare began to risk-adjust capitation payments to private Medicare Advantage (MA) plans to reduce selection-driven overpayments. But...

Community-rating regulations equalize the insurance premiums faced by the healthy and the unhealthy. Intended reductions in the unhealthy's premiums can be undone, however, if the healthy forgo coverage. The severity of this adverse selection problem hinges largely on how health care costs are...

This 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....

The Patient Protection and Affordable Care Act of 2010 mandates that young adults be able to stay on parental health insurance until age 26. This paper creates a new algorithm to identify individuals with parental health insurance. Using an age/time difference-in-difference analysis, it finds...

I exploit the age-based eligibility structure of Medicare and the age gap between spouses to examine the impact of Medicare eligibility of an older spouse on the insurance coverage of younger, Medicare-ineligible spouses. Using a regression discontinuity framework, I find that Medicare...

Long-term care expenditures constitute one of the largest uninsured financial risks facing the elderly in the United States and thus play a central role in determining the retirement security of elderly Americans. In this essay, we begin by providing some background on the nature and extent of...