Horizontal and vertical equity and public subsidies for private health insurance in the U.S

Paul D. Jacobs and Steven C. Hill

Social Science & Medicine, 2024, vol. 351, issue C

Abstract: The United States offers two markedly different subsidy structures for private health insurance. When covered through employer-based plans, employees and their dependents benefit from the exclusion from taxable income of the premiums. Individuals without access to employer coverage may obtain subsidies for Marketplace coverage. This paper seeks to understand how the public subsidies embedded in the privately financed portion of the U.S. healthcare system impact the payments families are required to make under both ESI and Marketplace coverage, and the implications for finance equity.

Keywords: Equity; Vertical equity; Horizontal equity; Health insurance coverage; Out-of-pocket spending; Public subsidies; Gini coefficient; Lorenz curve (search for similar items in EconPapers)
Date: 2024
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DOI: 10.1016/j.socscimed.2024.116994

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