Health insurance coverage and take-up: Lessons from behavioral economics

Milbank Quarterly

Volumn 90, Issue 1, 2012, Pages 107-134

  Baicker, Katherine ^a   Congdon, William J ^b   Mullainathan, Sendhil ^c  

^a HARVARD SCHOOL OF PUBLIC HEALTH   (United States)

^b BROOKINGS INSTITUTION   (United States)

^c HARVARD UNIVERSITY   (United States)

Author keywords

behavioral economics; Health insurance; health policy; uninsured

Indexed keywords

ARTICLE; BEHAVIOR; DECISION MAKING; HEALTH CARE POLICY; HEALTH INSURANCE; HUMAN; MEDICAID; MEDICARE; PRESCRIPTION; PRIORITY JOURNAL; SOCIAL ASPECT; UNITED STATES;

ADULT; CHILD; CHILD WELFARE; DECISION MAKING; ECONOMICS, BEHAVIORAL; HEALTH BENEFIT PLANS, EMPLOYEE; HEALTH CARE REFORM; HEALTH POLICY; HUMANS; INSURANCE COVERAGE; INSURANCE, HEALTH; MEDICAID; MEDICALLY UNINSURED; PATIENT PROTECTION AND AFFORDABLE CARE ACT; UNITED STATES;

EID: 84859089766     PISSN: 0887378X     EISSN: 14680009     Source Type: Journal    
DOI: 10.1111/j.1468-0009.2011.00656.x     Document Type: Article

References (80)

1. Abaluck, J., and, J. Gruber,. 2011. Choice Inconsistencies among the Elderly: Evidence from Plan Choice in the Medicare Part D Program. American Economic Review 101 (4): 1180-1210.
2. Aizer, A., 2003. Low Take-Up in Medicaid: Does Outreach Matter and for Whom? American Economic Review 93 (2): 238-41. (Pubitemid 38799629)
3. Aizer, A., 2007. Public Health Insurance, Program Take-Up, and Child Health. Review of Economics and Statistics 89 (3): 400-415.
4. Andreoni, J., and, J.H. Miller,. 2002. Giving According to GARP: An Experimental Test of the Consistency of Preferences for Altruism. Econometrica 70 (2): 737-53. (Pubitemid 34269067)
5. Arrow, K.J., 1963. Uncertainty and the Welfare Economics of Medical Care. American Economic Review 53 (5): 941-73.
6. Baicker, K., and, A. Finkelstein,. 2011. The Effects of Medicaid Coverage-Learning from the Oregon Experiment. New England Journal of Medicine 365 (10): 683-85.
7. Bansak, C., and, S. Raphael,. 2006. The Effects of State Policy Design Features on Take-Up and Crowd-Out Rates for the State Children's Health Insurance Program. Journal of Policy Analysis and Management 26 (1): 149-75.
8. Bertrand, M., S. Mullainathan, and, E. Shafir,. 2006. Behavioral Economics and Marketing in Aid of Decision Making among the Poor. Journal of Public Policy & Marketing 25 (1): 8-23. (Pubitemid 43935641)
9. Bundorf, M.K., and, M.V. Pauly,. 2006. Is Health Insurance Affordable for the Uninsured? Journal of Health Economics 25 (4): 650-73. (Pubitemid 43994194)
10. Bundorf, M.K., and, H. Szrek,. 2010. Choice Set Size and Decision Making: The Case of Medicare Part D Prescription Drug Plans. Medical Decision Making 30 (5): 582-93.
11. CBO (Congressional Budget Office). 2010. H.R. 4872, Reconciliation Act of 2010 (Final Health Care Legislation), March 20.
12. Chernew, M., K. Frick, and, C.G. McLaughlin,. 1997. The Demand for Health Insurance Coverage by Low-Income Workers: Can Reduced Premiums Achieve Full Coverage? Health Services Research 32 (4): 453-70. (Pubitemid 27419311)
13. Chetty, R., A. Looney, and, K. Kroft,. 2009. Salience and Taxation: Theory and Evidence. American Economic Review 99 (4): 1145-77.
14. Clemens-Cope, L., and, B. Garrett,. 2006. Changes in Employer-Sponsored Health Insurance Sponsorship, Eligibility, and Participation: 2001-2005. Washington, DC: Kaiser Commission on Medicaid and the Uninsured.
15. CMS (Centers for Medicare and Medicaid Services). 2011. Informing CHIP and Medicaid Outreach and Education. CMS Report.
16. Coate, S., 1995. Altruism, the Samaritan's Dilemma, and Government Transfer Policy. American Economic Review 85 (1): 46-57.
17. Currie, J., 2000. Do Children of Immigrants Make Differential Use of Public Health Insurance? In Issues in the Economics of Immigration, ed., G. Borjas, 271-308. Chicago: University of Chicago Press.
18. Currie, J., 2006. The Take-Up of Social Benefits. In Public Policy and the Income Distribution, ed., A.J. Auerbach, D. Card, and, J.M. Quigley, 80-148. New York: Russell Sage.
19. Currie, J., and, J. Gruber,. 1996. Health Insurance Eligibility, Utilization of Medical Care, and Child Health. Quarterly Journal of Economics 111 (2): 431-66.
20. Cutler, D.M., and, J. Gruber,. 1997. Medicaid and Private Insurance: Evidence and Implications. Health Affairs 16 (1): 194-200. (Pubitemid 127463771)
21. Davidoff, A., A. Yemane, and, E. Adams,. 2005. Health Coverage for Low-Income Adults: Eligibility and Enrollment in Medicaid and State Programs, 2002. Kaiser Family Foundation Policy Brief.
22. DellaVigna, S., 2009. Psychology and Economics: Evidence from the Field. Journal of Economic Literature 47 (2): 315-72.
23. DeNavas-Walt, C., B.D. Proctor, and, J.C. Smith,. 2011. Income, Poverty, and Health Insurance Coverage in the United States: 2010. Washington, DC: U.S. Government Printing Office.
24. Diehr P., C.W. Madden, A. Cheadle, D.P. Martin, D.L. Patrick, and, S. Skillman,. 1996. Will Uninsured People Volunteer for Voluntary Health Insurance? Experience from Washington State. American Journal of Public Health 86 (4): 529-32. (Pubitemid 26125033)
25. Dorn, S., B. Garrett, C. Perry, L. Clemans-Cope, and, A. Lucas,. 2009. Nine in Ten: Using the Tax System to Enroll Eligible, Uninsured Children into Medicaid and SCHIP. Washington, DC: Urban Institute.
26. Duflo, E., W.G. Gale, J.B. Liebman, P. Orszag, and, E. Saez,. 2006. Saving Incentives for Low and Middle Income Families: Evidence from a Field Experiment with H&R Block. Quarterly Journal of Economics 121 (4): 1311-46. (Pubitemid 44888175)
27. Duggan, M.G., 2000. Hospital Ownership and Public Medical Spending. Quarterly Journal of Economics 115 (4): 1343-73.
28. Esponda, I., 2008. Behavioral Equilibrium in Economies with Adverse Selection. American Economic Review 98 (4): 1269-91.
29. Fang, H., M.P. Keane, and, D. Silverman,. 2008. Sources of Advantageous Selection: Evidence from the Medigap Insurance Market. Journal of Political Economy 116 (2): 303-50.
30. Finkelstein, A., S. Taubman, B. Wright, M. Bernstein, J. Gruber, J.P. Newhouse, H. Allen, K. Baicker, and Oregon Health Study Group. 2011. The Oregon Health Insurance Experiment: Evidence from the First Year. NBER Working Paper no. 17190.
31. Frank, R.G., 2007. Behavioral Economics and Health Economics. In Behavioral Economics and Its Applications, ed., P. Diamond, and, H. Vartiainen, 195-222. Princeton, NJ: Princeton University Press.
32. Frey, B.S., and, B. Torgler,. 2007. Tax Morale and Conditional Cooperation. Journal of Comparative Economics 35 (1): 136-59.
33. Fronstin, P., 2007. Employment-Based Health Benefits: Access and Coverage, 1988-2005. EBRI Issue Brief 303.
34. GAO (General Accounting Office). 2004. Medicare Savings Programs: Results of Social Security Administration's 2002 Outreach to Low-Income Beneficiaries.
35. Gruber, J., and, E. Washington,. 2005. Subsidies to Employee Health Insurance Premiums and the Health Insurance Market. Journal of Health Economics 24 (2): 253-76. (Pubitemid 40249767)
36. Handel, B.R., 2011. Adverse Selection and Switching Costs in Health Insurance Markets: When Nudging Hurts. NBER Working Paper no. 17459.
37. Heiss, F., D. McFadden, and, J. Winter,. 2006. Who Failed to Enroll in Medicare Part D, and Why? Early Results. Health Affairs 25 (5): w344-54. (Pubitemid 44497607)
38. Holahan, J., and, G. Kenney,. 2008. Health Insurance Coverage of Young Adults: Issues and Broader Considerations. Washington, DC: Urban Institute.
39. Hsee, C.K., S. Blount, G.F. Loewenstein, and, M.H. Bazerman,. 1999. Preference Reversals between Joint and Separate Evaluations of Options: A Review and Theoretical Analysis. Psychological Bulletin 125 (5): 576-90.
40. Huberman, G., S. Iyengar, and, W. Jiang,. 2004. How Much Choice Is Too Much: Determinants of Individual Contributions in 401(k) Retirement Plans. In Pension Design and Structure: New Lessons from Behavioral Finance, ed., O.S. Mitchell, and, S. Utkus, 83-95. New York: Oxford University Press.
41. Institute of Medicine. 2009. America's Uninsured Crisis: Consequences for Health and Health Care. Washington, DC: National Academies Press.
42. Iyengar, S., and, M.R. Lepper,. 2000. When Choice Is Demotivating: Can One Desire Too Much of a Good Thing? Journal of Personality and Social Psychology 79 (6): 995-1006.
43. Johnson, E.J., J. Hershey, J. Meszaros, and, H. Kunreuther,. 1993. Framing, Probability Distortions, and Insurance Decisions. Journal of Risk and Uncertainty 7: 35-51.
44. Kahneman, D., J.L. Knetsch, and, R. Thaler,. 1986. Fairness as a Constraint on Profit Seeking: Entitlements in the Market. American Economic Review 76 (4): 728-41.
45. Kahneman, D., and, A. Tversky,. 1979. Prospect Theory: An Analysis of Decision under Risk. Econometrica 47 (2): 263-91.
46. Kaiser Family Foundation. 2011. Employer Health Benefits 2011 Annual Survey. Kaiser Family Foundation and Health Research and Educational Trust.
47. Kenney, G.M., J. Haley, and, L. Dubay,. 2001. How Familiar Are Low-Income Parents with Medicaid and SCHIP? Washington, DC: Urban Institute.
48. Kenney, G.M., V. Lynch, J. Haley, M. Huntress, D. Resnick, and, C. Coyer,. 2011. Gains for Children: Increased Participation in Medicaid and CHIP in 2009. Washington, DC: Urban Institute.
49. Kling, J.R., S. Mullainathan, E. Shafir, L. Vermeulen, and, M.V. Wrobel,. 2012. Comparison Friction: Experimental Evidence from Medicare Drug Plans. Quarterly Journal of Economics 127 (1): 199-235.
50. Kopczuk, W., and, C. Pop-Eleches,. 2007. Electronic Filing, Tax Preparers and Participation in the Earned Income Tax Credit. Journal of Public Economics 91 (7-8): 1351-67.
51. Kunreuther, H., and, M. Pauly,. 2005. Insurance Decision-Making and Market Behavior. Foundations and Trends in Microeconomics 1 (2): 63-127.
52. Laibson, D., 1997. Golden Eggs and Hyperbolic Discounting. Quarterly Journal of Economics 112 (2): 443-78. (Pubitemid 127077767)
53. Levinson, A., and, S. Rahardja,. 2004. Medicaid Stigma. Georgetown University Working Paper.
54. Levy, H., and, T. DeLeire,. 2008. What Do People Buy When They Don't Buy Health Insurance and What Does That Say about Why They Are Uninsured? Inquiry 45 (4): 365-79.
55. Levy, H., and, D. Weir,. 2009. Take-Up of Medicare Part D: Results from the Health and Retirement Study. NBER Working Paper no. 14692.
56. Lewin, K., 1951. Field Theory in Social Science. New York: Harper.
57. Liebman, J.B., and, R.J. Zeckhauser,. 2004. Schmeduling. Harvard University Working Paper.
58. Liebman, J.B., and, R.J. Zeckhauser,. 2008. Simple Humans, Complex Insurance, Subtle Subsidies. In Using Taxes to Reform Health Insurance: Pitfalls and Promises, ed., H. Aaron, and, L. Burman, 230-62. Washington, DC: Brookings Institution Press.
59. Loewenstein, G., 2005. Hot-Cold Empathy Gaps and Medical Decision-Making. Health Psychology 24 (4): S49-56. (Pubitemid 41099125)
60. Madrian, B.C., and, D.F. Shea,. 2001. The Power of Suggestion: Inertia in 401(k) Participation and Savings Behavior. Quarterly Journal of Economics 116 (4): 1149-87. (Pubitemid 33585366)
61. Massachusetts Division of Health Care Finance and Policy. 2010. Health Care in Massachusetts: Key Indicators.
62. McWilliams, J.M., C.C. Afendulis, T.G. McGuire, and, B.E. Landon,. 2011. Complex Medicare Advantage Choices May Overwhelm Seniors-Especially Those with Impaired Decision Making. Health Affairs 30 (9): 1786-94.
63. Moffitt, R.A., 1983. An Economic Model of Welfare Stigma. American Economic Review 73 (5): 1023-35.
64. O'Donoghue, T., and, M. Rabin,. 1999. Doing It Now or Later. American Economic Review 89 (1): 103-24.
65. Olson, L.M., S.F. Tang, and, P.W. Newacheck,. 2005. Children in the United States with Discontinuous Health Insurance Coverage. New England Journal of Medicine 353 (4): 382-91. (Pubitemid 41132343)
66. Rabin, M., 1998. Psychology and Economics. Journal of Economic Literature 36 (1): 11-46. (Pubitemid 128461584)
67. Remler, D., and, S.A. Glied,. 2003. What Can the Take-Up of Other Programs Teach Us about How to Improve Take-Up of Health Insurance Programs? American Journal of Public Health 93: 67-74. (Pubitemid 36055275)
68. Rice, T., Y. Hanoch, and, J. Cummings,. 2010. What Factors Influence Seniors' Desire for Choice among Health Insurance Options? Health Economics, Policy and Law 5 (4): 437-57.
69. Samuelson, W., and, R. Zeckhauser,. 1988. Status Quo Bias in Decision Making. Journal of Risk and Uncertainty 1: 7-59.
70. Sandroni, A., and, F. Squintani,. 2007. Overconfidence, Insurance, and Paternalism. American Economic Review 97 (5): 1994-2004.
71. Schultz, P.W., J.M. Nolan, R.B. Cialdini, N.J. Goldstein, and, V. Griskevicius,. 2007. The Constructive, Destructive, and Reconstructive Power of Social Norms. Psychological Science 18 (5): 429-34.
72. Slovic, P., B. Fischhoff, S. Lichtenstein, B. Corrigan, and, B. Combs,. 1977. Preference for Insuring against Probable Small Losses: Insurance Implications. Journal of Risk and Insurance 44 (2): 237-58.
73. Sorenson, A., 2006. Social Learning and Health Plan Choice. RAND Journal of Economics 37 (4): 1-29.
74. Stuber, J., and, K. Kronebusch,. 2004. Stigma and Other Determinants of Participation in TANF and Medicaid. Journal of Policy Analysis and Management 23 (3): 509-30. (Pubitemid 38882784)
75. Stuber, J.P., K.A. Maloy, S. Rosenbaum, and, K.C. Jones,. 2000. Beyond Stigma: What Barriers Actually Affect the Decisions of Low-Income Families to Enroll in Medicaid? George Washington University Working Paper.
76. Thaler, R.H., and, C.R. Sunstein,. 2008. Nudge. New Haven, CT: Yale University Press.
77. Tversky, A., 1972. Elimination by Aspects: A Theory of Choice. Psychological Review 79 (4): 281-99.
78. Tversky, A., and, E. Shafir,. 1992. Choice under Conflict: The Dynamics of Deferred Decision. Psychological Science 3 (6): 358-61.
79. Ubel, P.A., G. Loewenstein, N. Schwarz, and, D. Smith,. 2005. Misimagining the Unimaginable: The Disability Paradox and Health Care Decision Making. Health Psychology 24 (4): S57-62. (Pubitemid 41099126)
80. Weinstein, N.D., 1980. Unrealistic Optimism about Future Life Events. Journal of Personality and Social Psychology 39 (5): 806-20.