Pashchenko, Svetlana and Porapakkarm, Ponpoje (2013): Cross-subsidization in employer-based health insurance and the effects of tax subsidy reform.
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Abstract
A major source of insurance coverage for non-elderly adults in the US is the employer-based health insurance market. Every participant in this market receives a tax subsidy because premiums are excluded from taxable income. However, people have different incentives to participate in the employer-based pool - since premiums are independent of individual risk, high-risk individuals receive implicit cross-subsidies from low-risk individuals. In this paper, we explore several ways to reform the tax subsidy by taking this implicit cross- subsidization into account. Using a general equilibrium heterogeneous agents model, we find that even though the complete elimination of the tax subsidy leads to the unraveling of the employer-based pool, there is still room for substantial savings by targeting the tax subsidy. More specifically, the same level of risk-sharing in the employer-based market can be achieved at one- third of the current costs if i) the tax subsidy is targeted only towards low- risk individuals who have weak incentives to participate in the pool, and ii) employer-based insurance premiums become age-adjusted. To improve the welfare outcome of this reform, the modified tax subsidy should also be targeted to low-income individuals.
Item Type: | MPRA Paper |
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Original Title: | Cross-subsidization in employer-based health insurance and the effects of tax subsidy reform |
Language: | English |
Keywords: | health insurance, tax subsidies, risk sharing, general equilibrium, life-cycle |
Subjects: | D - Microeconomics > D5 - General Equilibrium and Disequilibrium > D52 - Incomplete Markets D - Microeconomics > D9 - Intertemporal Choice > D91 - Intertemporal Household Choice ; Life Cycle Models and Saving E - Macroeconomics and Monetary Economics > E2 - Consumption, Saving, Production, Investment, Labor Markets, and Informal Economy E - Macroeconomics and Monetary Economics > E2 - Consumption, Saving, Production, Investment, Labor Markets, and Informal Economy > E21 - Consumption ; Saving ; Wealth E - Macroeconomics and Monetary Economics > E6 - Macroeconomic Policy, Macroeconomic Aspects of Public Finance, and General Outlook > E65 - Studies of Particular Policy Episodes H - Public Economics > H2 - Taxation, Subsidies, and Revenue > H20 - General I - Health, Education, and Welfare > I1 - Health > I10 - General |
Item ID: | 71404 |
Depositing User: | Svetlana Pashchenko |
Date Deposited: | 18 May 2016 14:15 |
Last Modified: | 26 Sep 2019 09:01 |
References: | [1] Aizawa, N., Fang, H., 2012. Equilibrium Labor Market Search and Health Insurance Reform. Mimeo, University of Pennsylvania. [2] Attanasio, O., Kitao, S., Violante G., 2011. Financing Medicare: A General Equi- librium Analysis. In Shoven, J.B. (Ed.), Demography and the Economy, University of Chicago Press. [3] Capatina, E., 2014. Life-cycle Effects of Health Risk. Journal of Monetary Economics [4] Congressional Budget Office, 2015. The 2015 Long-Term Budget Out- look. Available at https://www.cbo.gov/sites/default/files/114th-congress-2015- 2016/reports/50250-LongTermBudgetOutlook-4.pdf [5] Chernew, M., Frick, K. McLaughlin, C., 1997. The Demand for Health Insurance Coverage by Low-Income Workers: Can Reduced Premiums Achieve Full Coverage? Health Services Research, 32 (4): 453-470. [6] Clemens, J., 2012. ”Regulatory Redistribution in the Market for Health Insurance”. NBER Working paper 19904. [7] Cutler, D., and Zeckhauser, R., 1998. Adverse Selection in Health Insurance. In Frontiers in Health Policy Research, Volume 1, Alan Garber, 1-31. Cambridge: Mit Press. [8] De Nardi, M., French, E., Jones, J., 2010. Why Do the Elderly Save? Journal of Political Economy, 118(1), 39-75. [9] Erosa, A., Fuster, L., Kambourov, G. 2011 Towards a micro-founded theory of aggregate labor supply. IMDEA Working Papers N 2011-13. [10] Feng, Z., Zhao, K., 2014. Employment-based Health Insurance, Uncertain Medical Expenses, and Aggregate Labor Supply. Mimeo, University of Connecticut. [11] Floden, M., 2008. A Note on the Accuracy of Markov-chain Approximations to Highly Persistent AR(1) Processes. Economic Letters 99(3), 516-520. [12] French, E., 2005. The Effects of Health, Wealth, and Wages on Labor Supply and Retirement Behaviour. Review of Economic Studies, 72(2), 395-427. [13] Gouveia, M., Strauss, R., 1994. Effective Federal Individual Income Tax Functions: An Exploratory Empirical Analysis. National Tax Journal, 47(2), 317-339. [14] Gruber, J., 1994. ”The Incidence of Mandated Maternity Benefits”. American Eco- nomic Review, Vol. 84, No. 3, pp. 622-641 [15] Gruber, J., 2011. The Tax Exclusion for Employer-Sponsored Health Insurance. National Tax Journal, 64 (2), 511-530. [16] Gruber, J., and Washington, E., 2005. Subsidies to Employee Health Insurance Premiums and the Health Insurance Market. Journal of Health Economics, 24: 253- 276. [17] Hai, R., 2012. The Determinants of Rising Inequality in Health Insurance and Wages: An Equilibrium Model of Workers’ Compensation and Health Care Policies. Mimeo, University of Pennsylvania. [18] Hansen, G., Hsu, M., Lee, J., 2014. Health Insurance Reform: The impact of a Medicare Buy-In. Journal of Economic Dynamics and Control, 45, 315-329. [19] Heathcote, J., Storesletten, K., Violante, G. 2010 The Macroeconomic Implications of Rising Wage Inequality in the United States. Journal of Political Economy, 118(4), 681-722. [20] Hsu, M., 2013. Health Insurance and Precautionary Saving: A Structural Analysis. Review of Economic Dynamics, 16:3, 511-526. [21] Hubbard, G., Skinner, J., Zeldes, S., 1994. The Importance of Precautionary Mo- tives in Explaining Individual and Aggregate Saving. Carnegie-Rochester Conference Series on Public Policy 40(1), 59-125. [22] Hugget, R., 1993. The Risk-free Rate in Heterogeneous-Agent Incomplete-insurance Economies. Journal of Economic Dynamics and Control 17, 953-969 [23] Imrohoroglu, A., 1989. Cost of Business Cycles with Indivisibilities and Liquidity Constraints. Journal of Political Econoomy, 97(6), 1364-1383. [24] Imrohoroglu, S., Kitao, S., 2011. Social Security Reforms: Benefit Claiming, La- bor Force Participation and Long-run Sustainability. American Economic Journal: Macroeconomics, forthcoming. [25] Jeske, K., Kitao, S., 2009. U.S. Tax Policy and Health Insurance Demand: Can a Regressive Policy Improve Welfare? Journal of Monetary Economics, 56(2), 210-221. [26] Joint Committee on Taxation, 2015. Estimates of Federal Tax Expenditures for Fiscal Years 2015-2019. Manuscript JCX-141R-15 [27] Kaiser Family Foundation, 2009. Employer Health Benefits Survey. Available at http://ehbs.kff.org/2009.html [28] Kaiser Family Foundation, 2011. Summary of New Health Reform Law. Available at www.kff.org/healthreform/upload/8061.pdf [29] Kahn, J., Kronick, R., Kreger, M., Gans, D. 2005. The Cost of Health Insurance Ad- ministration in California: estimates for insurers, physicians, and hospitals. Health Affairs 24. [30] Kennickel, A., 2006. Currents and Undercurrents: Changes in the Distribution of Wealth, 1989-2004. Mimeo, Federal Reserve Board. [31] Kim, S., 2012. The Labor Supply and Welfare Effects of Early Access to Medicare through Social Security Disability Insurance. Mimeo, Ohio State University. [32] Kopecky, K., Koreshkova, T., 2013. The Impact of Medical and Nursing Home Expenses on Savings. forthcoming at American Economic Journal: Macroeconomics. [33] Ozkan, S., 2011. Income Differences and Health Care Expenditures over the Life Cycle. Mimeo, Federal Reserve Board. [34] Pashchenko, S., Porapakkarm, P., 2013. Quantitative Analysis of Health Insurance Reform: Separating Regulation from Redistribution. Review of Economic Dynamics, 16: 383-404. [35] Pashchenko, S., Porapakkarm, P., 2015a. Welfare Costs of Reclassification Risk in the Health Insurance Market. Journal of Macroeconomics. [36] Pashchenko, S., Porapakkarm, P., 2015b. Reducing Medical Spedning of the Publicly Insured. Mimeo, University of Georgia [37] Pauly, 2001. Making Sense of a Complex System, Empirical Studies of Employment-Based Health Insurance. International Journal of Health Care Finance and Economics. [38] Prados, M., 2012. Health And Earnings Inequality Over The Life Cycle: The Redistributive Potential of Health Policies. Mimeo, Columbia University. [39] Ross, D., Jarlenski, J., Artiga, S., Marks, C., 2009. A Foundation for Health Reform: Findings of a 50 State Survey of Eligibility Rules, Enrollment and Renewal Proce- dures, and Cost-Sharing Practices in Medicaid and CHIP for Children and Parents during 2009. Kaiser Commission on Mediaid and the Uninsured. [40] St-Amour, P., 2012. Life Cycle Responses to Medicare. Manuscript, University of Lausanne. [41] Storesletten, K., Telmer, C., Yaron, Y., 2004. Consumption and Risk Sharing Over the Life Cycle. Journal of Monetary Economics 51(3), 609-633. [42] Tauchen, G., Hussey, R., 1991. Quadrature-Based Methods for Obtaining Approxi- mate Solutions to Nonlinear Asset Pricing Models. Econometrica 59(2), 371-396. [43] Wolff, E., 2010. Recent Trends in Household Wealth in the United States: Rising Debt and the Middle-Class Squeeze—an Update to 2007. Levy Economics Institute of Bard College Working Paper No. 589. [44] Young, E., 2010. Solving the Incomplete Markets Model with Aggregate Uncer- tainty Using the Krusell-Smith Algorithm and Non-Stochastic Simulations. Journal of Economic Dynamics and Control, 34(1), 36-41. [45] Zhao, J. (2014). Social Security and the Rise in Health Spending. Journal of Monetary Economics, 64. |
URI: | https://mpra.ub.uni-muenchen.de/id/eprint/71404 |
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Cross-subsidization in employer-based health insurance and the effects of tax subsidy reform. (deposited 07 Jul 2013 09:16)
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Cross-subsidization in employer-based health insurance and the effects of tax subsidy reform. (deposited 30 Apr 2014 00:06)
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Cross-subsidization in employer-based health insurance and the effects of tax subsidy reform. (deposited 30 Apr 2014 00:06)