Do Ordeals Work for Selection Markets? Evidence from Health Insurance Auto-Enrollment
中文摘要
申请手续带来的麻烦，即“繁琐程序”（ordeal），是否是限制公共项目参保的有效方式？我们通过研究一项医疗保险自动参保政策的（取消），提供了新证据——取消该政策意味着参保时需增加一个额外步骤。这一看似轻微的繁琐程序产生了重大影响，使参保率下降33%，并不成比例地将年轻、健康和经济处境不利的人群排除在外。利用一个简单模型，我们表明，逆向选择——保险市场的典型特征——削弱了繁琐程序排除低价值个体这一标准理由，因为这些低价值个体同时也是低成本个体，将其排除未必是有效率的。我们的分析说明了为何以繁琐程序作为筛选手段，在选择型市场中不太可能奏效。（JEL D82, G22, H75, I13, I18）
Abstract
Are application hassles, or “ordeals,” an effective way to limit public program enrollment? We provide new evidence by studying (removal of) an auto-enrollment policy for health insurance, adding an extra step to enroll. This minor ordeal has a major impact, reducing enrollment by 33 percent and differentially excluding young, healthy, and economically disadvantaged people. Using a simple model, we show adverse selection—a classic feature of insurance markets—undermines ordeals’ standard rationale of excluding low-value individuals since they are also low-cost and may not be inefficient. Our analysis illustrates why ordeals targeting is unlikely to work well in selection markets. (JEL D82, G22, H75, I13, I18)