Modeling Health Insurance Expansions: Effects of Alternate Approaches

27 Pages Posted: 30 Aug 2002 Last revised: 23 Oct 2009

See all articles by Dahlia Remler

Dahlia Remler

City University of New York - Baruch College - Marxe School of Public and International Affairs; National Bureau of Economic Research (NBER); CUNY The Graduate Center - Department of Economics

Joshua Graff Zivin

Columbia University - Department of Health Policy and Management; National Bureau of Economic Research (NBER)

Sherry Glied

Dean; National Bureau of Economic Research (NBER)

Date Written: August 2002

Abstract

Estimates of the costs and consequences of many types of public policy proposals play an important role in the development and adoption of particular policy programs. Estimates of the same, or similar, policies that employ different modeling approaches can yield widely divergent results. Such divergence often undermines effective policy-making. These problems are particularly prominent for health insurance expansion programs. Concern focuses on predictions of the numbers of individuals that will be insured and the costs of the proposals. Several different simulation modeling approaches are used to predict these effects, making the predictions difficult to compare. In this paper, we do the following: (1) We categorize and describe the different approaches used; (2) we explain the conceptual and theoretical relationships between the methods; (3) we demonstrate empirically an example of the (quite restrictive) conditions under which all approaches can yield quantitatively identical predictions; and (4) we empirically demonstrate conditions under which the approaches diverge and the quantitative extent of that divergence. All modeling approaches implicitly make assumptions about functional form that impose restrictions on unobservable heterogeneity. Those assumptions can dramatically affect the quantitative predictions made.

Suggested Citation

Remler, Dahlia and Zivin, Joshua Graff and Glied, Sherry A., Modeling Health Insurance Expansions: Effects of Alternate Approaches (August 2002). NBER Working Paper No. w9130, Available at SSRN: https://ssrn.com/abstract=327156

Dahlia Remler

City University of New York - Baruch College - Marxe School of Public and International Affairs ( email )

135 E 22nd St
New York, NY 10010
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National Bureau of Economic Research (NBER) ( email )

1050 Massachusetts Avenue
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CUNY The Graduate Center - Department of Economics ( email )

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New York, NY 10016
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Joshua Graff Zivin

Columbia University - Department of Health Policy and Management ( email )

600 West 168th Street, 6th Floor
New York, NY 10032
United States

National Bureau of Economic Research (NBER)

1050 Massachusetts Avenue
Cambridge, MA 02138
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Sherry A. Glied (Contact Author)

Dean ( email )

The Puck Building
295 Lafayette Street, Second Floor
New York, NY 10012
United States

National Bureau of Economic Research (NBER)

1050 Massachusetts Avenue
Cambridge, MA 02138
United States

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