Health Reform, Health Insurance, and Selection: Estimating Selection into Health Insurance Using the Massachusetts Health Reform

8 Pages Posted: 14 Jan 2012 Last revised: 1 Jul 2021

See all articles by Martin B. Hackmann

Martin B. Hackmann

University of California, Los Angeles (UCLA); National Bureau of Economic Research (NBER)

Jonathan T. Kolstad

University of Pennsylvania - Health Care Systems Department

Amanda Kowalski

University of Michigan at Ann Arbor - Department of Economics

Multiple version iconThere are 2 versions of this paper

Date Written: January 2012

Abstract

We implement an empirical test for selection into health insurance using changes in coverage induced by the introduction of mandated health insurance in Massachusetts. Our test examines changes in the cost of the newly insured relative to those who were insured prior to the reform. We find that counties with larger increases in insurance coverage over the reform period face the smallest increase in average hospital costs for the insured population, consistent with adverse selection into insurance before the reform. Additional results, incorporating cross-state variation and data on health measures, provide further evidence for adverse selection.

Suggested Citation

Hackmann, Martin B. and Kolstad, Jonathan T. and Kowalski, Amanda, Health Reform, Health Insurance, and Selection: Estimating Selection into Health Insurance Using the Massachusetts Health Reform (January 2012). NBER Working Paper No. w17748, Available at SSRN: https://ssrn.com/abstract=1985081

Martin B. Hackmann (Contact Author)

University of California, Los Angeles (UCLA) ( email )

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Jonathan T. Kolstad

University of Pennsylvania - Health Care Systems Department ( email )

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Amanda Kowalski

University of Michigan at Ann Arbor - Department of Economics ( email )

Ann Arbor, MI
United States

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