Screening in Contract Design: Evidence from the ACA Health Insurance Exchanges

Michael Geruso, Timothy Layton and Daniel Prinz ()

No 22832, NBER Working Papers from National Bureau of Economic Research, Inc

Abstract: We study insurers’ use of prescription drug formularies to screen consumers in the ACA Health Insurance Exchanges. We begin by showing that Exchange risk adjustment and reinsurance succeed in neutralizing selection incentives for most, but not all, consumer types. A minority of consumers, identifiable by demand for particular classes of prescription drugs, are predictably unprofitable. We then show that contract features relating to these drugs are distorted in a manner consistent with multi-dimensional screening. The empirical findings support a long theoretical literature examining how insurance contracts offered in equilibrium can fail to optimally trade-off risk protection and moral hazard.

JEL-codes: I11 I13 I18 (search for similar items in EconPapers)
Date: 2016-11
New Economics Papers: this item is included in nep-cta, nep-hea and nep-ias
Note: AG EH PE
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Citations: View citations in EconPapers (23)

Published as Michael Geruso & Timothy Layton & Daniel Prinz, 2019. "Screening in Contract Design: Evidence from the ACA Health Insurance Exchanges," American Economic Journal: Economic Policy, vol 11(2), pages 64-107.

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Journal Article: Screening in Contract Design: Evidence from the ACA Health Insurance Exchanges (2019)
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