The Affordable Care Act After a Decade: Industrial Organization of the Insurance Exchanges

Benjamin R. Handel and Jonathan Kolstad

No 29178, NBER Working Papers from National Bureau of Economic Research, Inc

Abstract: The regulated insurance exchanges set up in the Affordable Care Act (ACA) were designed to deliver affordable, efficient health coverage through private insurers. It is crucial to study the complex industrial organization (IO) of these exchanges in order to assess their impacts to date, during the first decade of the ACA, and in order to project their impacts going forward. We revisit the inherent market failures in health care markets that necessitate key ACA exchange regulations and investigate whether they have succeeded in their goals of expanding coverage, creating robust marketplaces, providing product variety, and generating innovation in health care delivery. We discuss empirical IO research to date and also highlight shortcomings in the existing research that can be addressed moving forward. We conclude with a discussion of IO research-based policy lessons for the ACA exchanges and, more generally, for managed competition of private insurance in health care.

JEL-codes: G22 H2 I11 I13 (search for similar items in EconPapers)
Date: 2021-08
New Economics Papers: this item is included in nep-com, nep-hea, nep-ias, nep-isf and nep-reg
Note: EH IO PE
References: View references in EconPapers View complete reference list from CitEc
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Published as Benjamin Handel & Jonathan Kolstad, 2022. "The Affordable Care Act After a Decade: Industrial Organization of the Insurance Exchanges," Annual Review of Economics, vol 14(1).

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