Experience in European health insurance exchanges indicates that even with the best risk-adjustment formulas, insurers have substantial incentives to engage in risk selection. The potentially most worrisome form of risk selection is skimping on the quality of care for underpriced high-cost patients--that is, patients for whom insurers are compensated at a rate lower than the predicted health ca...

Background: Health insurance literacy is a nascent concept that has emerged mainly after the implementation of the law known as Obamacare in the United States. This study seeks to identify the themes of health insurance literacy in Iranian society. Methods: The study approach is qualitative. Data were collected using nine semi-structured interviews, ten focal group meetings with the presence o...

A ubiquitous form of government intervention in insurance markets is to provide compulsory, but partial, public insurance coverage and to allow voluntary purchases of supplementary private insurance. This paper investigates the effects of such programs on insurance coverage for the risks not covered by the public program, using the example of the US Medicare program. I find that Medicare does n...

First-year insurer participation in the Health Insurance Marketplaces (HIMs) established by the Affordable Care Act is limited in many areas of the country. There are 3.9 participants, on (population-weighted) average, in the 395 ratings areas spanning the 34 states with federally facilitated marketplaces (FFMs). Using data on the plans offered in the FFMs, together with predicted market shares...

The healthcare service in Brazil comprises a public and universal system (Sistema Unico de Saude, SUS), but considerable part of the population (59.7 million) also maintains private health insurance as supplementary care.1 is regulated by an autonomous governmental agency, formally Agencia Nacional Saude Suplementar (ANS), which regulates relationship between users operators plans, including fi...

More than 35.6 million children were enrolled in Medicaid or the Children’s Health Insurance Program (CHIP) in December 2016— accounting for just over half of total Medicaid and CHIP enrollment.1 Medicaid and CHIP are particularly important in rural areas where 77.1 percent of children in households with income below 200 percent of the federal poverty level (FPL) are covered by public insurance...

The Health Insurance Portability and Accountability Act (HIPAA) of 1996 has been praised and criticized for asserting federal authority to regulate health insurance. We review the history of federalism and insurance regulation and find that HIPAA is less of a departure from traditional federal authority than it is an application of existing tools to meet evolving health policy goals. This inter...

Research shows consolidation in the private health insurance industry leads to premium increases, even though insurers with larger local market shares generally obtain lower prices from health care providers. Additional research is needed to understand how to protect against harms and unlock benefits from scale. Data on enrollment, premiums, and costs of commercial health insurance--by insurer,...