Advertising in Health Insurance Markets

Marketing Science, Forthcoming

52 Pages Posted: 5 Jun 2016 Last revised: 26 Jan 2019

See all articles by Bradley Shapiro

Bradley Shapiro

University of Chicago - Booth School of Business

Date Written: July 24, 2018


The effects of television advertising in the market for health insurance are of distinct interest to both firms and regulators. Regulators are concerned about firms potentially using ads to "cream skim," or attract an advantageous risk pool, as well as the potential for firms to use misinformation to take advantage of the elderly. Firms are interested in using advertising to acquire potentially highly profitable seniors. Meanwhile, health insurance is a useful setting to study the mechanisms through which advertising could work. Using the discontinuity in advertising exposure created by the borders of television markets, this study estimates the effects of advertising on consumer choice in health insurance. Television advertising has a small effect on brand enrollments, making advertising a relatively expensive means of acquiring customers. Heterogeneous effects point to advertising being more effective in less healthy counties, which runs opposite to the concern of cream skimming. Leveraging the unilateral cessation of advertising by United Healthcare, evidence is provided that the small advertising effect is not explained by a prisoner's dilemma equilibrium. An analysis of longer-run effects of advertising shows that advertising effects are short-lived, further decreasing the potential of advertising to create long run value to the firm.

Keywords: Advertising, Health Insurance, Health Economics, Marketing

JEL Classification: M31, M37, I11, I18, L51, H51

Suggested Citation

Shapiro, Bradley, Advertising in Health Insurance Markets (July 24, 2018). Marketing Science, Forthcoming, Available at SSRN: or

Bradley Shapiro (Contact Author)

University of Chicago - Booth School of Business ( email )

5807 S. Woodlawn Avenue
Chicago, IL 60637
United States


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