健康保险免赔额中的时间聚合
Time Aggregation in Health Insurance Deductibles
American Economic Journal: Economic Policy · 2024 · [{"name": "Long Hong", "affiliation": ["University of Wisconsin–Madison"]}, {"name": "Corina Mommaerts", "affiliation": ["University of Wisconsin–Madison"]}]
中文摘要
健康保险计划越来越多地仅支付超过较高年度免赔额的费用。本文探讨在较短时间跨度内重置免赔额的影响。我们构建了一个保险需求模型，用于比较两种精算等价的免赔额保单：一种免赔额较高且按年度重置，另一种免赔额较低且每半年重置一次。该模型纳入了借贷约束、道德风险、年中合同转换以及可推迟的医疗。基于理赔数据的校准结果表明，重置免赔额带来的流动性收益可产生相当于保费成本3%至10%的福利增益，对于存在借贷约束的个人而言尤为显著。
Abstract
Health insurance plans increasingly pay for expenses only beyond a large annual deductible. This paper explores the implications of deductibles that reset over shorter timespans. We develop a model of insurance demand between two actuarially equivalent deductible policies in which one deductible is larger and resets annually and the other deductible is smaller and resets biannually. Our model incorporates borrowing constraints, moral hazard, midyear contract switching, and delayable care. Calibrations using claims data show that the liquidity benefits of resetting deductibles can generate welfare gains of 3-10 percent of premium costs, particularly for individuals with borrowing constraints.