Consumer Choice in Health Insurance Exchanges: Can We Make It Work?

Nadash, Pamela; Day, Rosemarie

doi:10.1215/03616878-2395217

Cited by 11 publications

(8 citation statements)

References 61 publications

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“…In the United States, as the reconstruction of financial markets continues to transform the way that financial services and products are provided, financial decisions have become more complex. Meanwhile, American families are more than ever making financial decisions regarding retirement preparation and health‐care plans as responsibilities have increasingly been shifted to individuals from governments (Lusardi and Mitchell, ; Nadash and Day, ). Within this increasingly complex decision environment, the degree to which individuals have sufficient financial knowledge has become crucial in determining their current and long‐term financial well‐being.…”

mentioning

confidence: 99%

On the Gender Gap in Financial Knowledge: Decomposing the Effects of Don't Know and Incorrect Responses*

Chen

Garand

2018

Social Science Quarterly

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Objectives Past studies have consistently shown that women have lower levels of financial knowledge than men, and hence there is a noticeable gender gap in financial knowledge. We reconsider the conventional measures of financial knowledge by disentangling don't know (DK) responses and incorrect answers and comparing the effect of these two disparate responses’ on the gender gap in financial knowledge. Methods Using data from the 2012 National Financial Capability Studies data set, we estimate a series of ordinary least squares regression and multinomial logit models of the gender gap in DK and incorrect responses. Results We find a strong gender gap in financial knowledge, but with a twist: (1) men are more likely to offer correct answers; (2) women are slightly more likely to offer incorrect answers; but (3) women are considerably more likely to provide DK responses. Hence women may exhibit lower levels of financial knowledge because they lose the opportunity to hazard a guess and arrive at a correct answer based either on partial knowledge or on random chance. We consider the possibility that there are psychological processes at work involving risk acceptance and confidence in financial knowledge that prompt women to give DK responses at a rate higher than men. Conclusion We suggest that future research should consider the relative roles of DK and incorrect responses in measuring financial knowledge.

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confidence: 99%

On the Gender Gap in Financial Knowledge: Decomposing the Effects of Don't Know and Incorrect Responses*

Chen

Garand

2018

Social Science Quarterly

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“…[19][20][21] Low literacy and numeracy impede choice. 22,23 Simulated exercises of insurance exchange choices show that people's efforts to choose a cost-effective plan are no better than chance. 24 Moreover, simulations illustrate that although the actuarial value of a plan provides some information about its value, out-of-pocket spending can vary between plans of equal actuarial value.…”

mentioning

confidence: 99%

Examination of Parent Insurance Ratings, Child Expenditures, and Financial Burden Among Children With Autism: A Mismatch Suggests New Hypotheses to Test

et al. 2016

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OBJECTIVE: Families raising children with autism contribute significant amounts to the cost of care. In this era of health care reform, families have more insurance choices, but people are unfamiliar with health insurance terms. This study uses 2 national data sets to examine health insurance ratings from parents raising children with autism and child expenditures to explore how these measures align. METHODS:Children with autism who met criteria for special health care needs and were continuously insured were examined. Data from the National Survey of Children With Special Health Care Needs 2009-2010 were used to examine parent report of adequate insurance (n = 3702). Pooled data from the Medical Expenditure Panel Survey 2002-2011 were used to examine expenditures (n = 346). Types of health insurance included private alone, Medicaid alone, and combined private and wrap-around Medicaid. RESULTS:Having Medicaid doubled the odds of reporting adequate insurance compared with private insurance alone (P < .0001), and children on Medicaid had the lowest out-of-pocket costs ($150, P < .0001). Children covered by combined private and wrap-around Medicaid had the highest total expenditures ($11 596, P < .05) and the highest expenditures paid by their insurance ($10 638, P < .05). CONCLUSIONS:These findings highlight a mismatch between parent ratings of insurance adequacy, child expenditures, and relative financial burden. Findings generate a number of questions to address within single sources of data. By elaborating the frameworks families use to judge the adequacy of their insurance, future research can develop policy strategies to improve both their satisfaction with their insurance coverage and the service use of children with autism.

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“…In terms of search costs, evidence suggests that consumer decision-making deteriorates when confronted with too much choice [46,57,9,13,20]. Notably, Frank and Lamiraud [19] found that as the choice set offered to consumers in the Swiss health insurance system increased, their willingness to switch declined.…”

Section: Literature Reviewmentioning

confidence: 99%

Switching benefits and costs in the Irish health insurance market: an analysis of consumer surveys

Keegan

Teljeur

Turner

et al. 2018

Int J Health Econ Manag.

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Relatively little analysis has taken place internationally on the consumer-reported benefits and costs to switching insurer in multi-payer health insurance markets. Ideally, consumers should be willing to switch out of consideration for price and quality and switching should be able to take place without incurring significant switching costs. Costs to switching come in many forms and understanding the nature of these costs is necessary if policy interventions to improve market competition are to be successful. This study utilises data from consumer surveys of the Irish health insurance market collected between 2009 and 2013 (N [Formula: see text] 1703) to examine consumer-reported benefits and costs to switching insurer. Probit regression models are specified to examine the relationship between consumer characteristics and reported switching costs, and switching behaviour, respectively. Overall evidence suggests that switchers in the Irish market mainly did so out of consideration for price. Transaction cost was the most common switching cost identified, reported by just under 1 in 7 non-switchers. Psychological switching costs may also be impacting behaviour. Moreover, high-risk individuals were more likely to experience switching costs and this was reflected in actual switching behaviour. A recent information campaign launched by the market regulator may prove beneficial in reducing perceived transaction costs in the market, however, a more focused campaign aimed at high-risk consumers may be necessary to reduce inequalities. Policy-makers should also consider the impact insurer behaviour may have on decision-making.

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Consumer Choice in Health Insurance Exchanges: Can We Make It Work?

Cited by 11 publications

References 61 publications

On the Gender Gap in Financial Knowledge: Decomposing the Effects of Don't Know and Incorrect Responses*

On the Gender Gap in Financial Knowledge: Decomposing the Effects of Don't Know and Incorrect Responses*

Examination of Parent Insurance Ratings, Child Expenditures, and Financial Burden Among Children With Autism: A Mismatch Suggests New Hypotheses to Test

Switching benefits and costs in the Irish health insurance market: an analysis of consumer surveys

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