Working Papers
The Impacts of the Affordable Care Act Dependent Coverage Provision on College Graduates with Student Loan Debt (Job-Market Paper)
ABSTRACT: The Affordable Care Act (ACA) dependent coverage provision, implemented in 2010, requires private insurers to allow dependents to stay on parental policies until age 26. Using data from the PSID, we show that the take-up of the provision was higher among college graduates with more student loan debt. For a college graduate who is unable to benefit from the provision, we estimate that $10,000 in student loan debt is associated with a 3.1% decrease in the likelihood of having insurance and a 1.8% increase in the likelihood of skipping treatment in times of illness. On the other hand, our difference-in-difference analysis suggests that the likelihood of having insurance would increase 5.1% more after 2010 if that college graduate was eligible for the provision. Using data from the College Scorecard, we show that at the school level, a higher average eligibility for the provision led to a decrease in student loan default rate and an increase in student loan repayment rate after 2010.
Does Part D Abet Advantageous Selection in Medicare Advantage? (With Kurt Lavetti)
Accepted at Journal of Health Economics
Published on Dec 13, 2017, free access to the published paper available until Feb 01, 2018
ABSTRACT: The use of risk-adjustment formulae in setting payments to Medicare Advantage (MA) plans reduces the potential for advantageous selection on factors included in the formulae, but can potentially worsen overall selection if plans are able to target beneficiaries based on excluded factors. Since MA medical risk-adjustment excludes prescription drug utilization, demand for drugs can be exploited by plans to induce advantageous selection. We show evidence that the introduction of Medicare Part D provided a mechanism for MA plans to increase selection, and that consumers responded, increasing MA market shares among beneficiaries taking drugs associated with the strongest advantageous selection incentives. For the average Medicare beneficiary in our sample, we estimate that this change in advantageous selection following the introduction of Medicare Part D increased the probability of enrolling in an MA plan by about 7.1%.
The Impacts of the Affordable Care Act Dependent Coverage Provision on College Graduates with Student Loan Debt (Job-Market Paper)
ABSTRACT: The Affordable Care Act (ACA) dependent coverage provision, implemented in 2010, requires private insurers to allow dependents to stay on parental policies until age 26. Using data from the PSID, we show that the take-up of the provision was higher among college graduates with more student loan debt. For a college graduate who is unable to benefit from the provision, we estimate that $10,000 in student loan debt is associated with a 3.1% decrease in the likelihood of having insurance and a 1.8% increase in the likelihood of skipping treatment in times of illness. On the other hand, our difference-in-difference analysis suggests that the likelihood of having insurance would increase 5.1% more after 2010 if that college graduate was eligible for the provision. Using data from the College Scorecard, we show that at the school level, a higher average eligibility for the provision led to a decrease in student loan default rate and an increase in student loan repayment rate after 2010.
Does Part D Abet Advantageous Selection in Medicare Advantage? (With Kurt Lavetti)
Accepted at Journal of Health Economics
Published on Dec 13, 2017, free access to the published paper available until Feb 01, 2018
ABSTRACT: The use of risk-adjustment formulae in setting payments to Medicare Advantage (MA) plans reduces the potential for advantageous selection on factors included in the formulae, but can potentially worsen overall selection if plans are able to target beneficiaries based on excluded factors. Since MA medical risk-adjustment excludes prescription drug utilization, demand for drugs can be exploited by plans to induce advantageous selection. We show evidence that the introduction of Medicare Part D provided a mechanism for MA plans to increase selection, and that consumers responded, increasing MA market shares among beneficiaries taking drugs associated with the strongest advantageous selection incentives. For the average Medicare beneficiary in our sample, we estimate that this change in advantageous selection following the introduction of Medicare Part D increased the probability of enrolling in an MA plan by about 7.1%.