The Role of Behavioral Frictions in Health Insurance Marketplace Enrollment and Risk: Evidence from a Field Experiment
中文摘要
我们通过实验改变了邮寄给加州健康保险市场 87,000 户家庭的信息，以研究摩擦在保险参保中的作用。关于参保截止日期的提醒使这一通常参保率较低人群的参保率提高了 1.3 个百分点（16%）。个性化补贴信息的异质性效应表明，人们对该项目收益存在误解。与具有摩擦性参保成本的逆向选择模型一致，该干预使平均支出风险降低了 5.1%，这意味着边际响应者的成本比次边际消费者低 37%。我们在低收入消费者中观察到最大的正向选择，而他们在参保中表现出最大的摩擦。最后，我们估计该信函干预的隐含价值为每月 25 至 53 美元补贴金额。这些结果表明，摩擦可能部分解释了市场保险的低参保率，而减少摩擦的干预措施可以改善交易所的参保情况和市场风险。
Abstract
We experimentally varied information mailed to 87,000 households in California’s health insurance marketplace to study the role of frictions in insurance take-up. Reminders about the enrollment deadline raised enrollment by 1.3 pp (16 percent) in this typically low take-up population. Heterogeneous effects of personalized subsidy information indicate misperceptions about program benefits. Consistent with an adverse selection model with frictional enrollment costs, the intervention lowered average spending risk by 5.1 percent, implying that marginal respondents were 37 percent less costly than inframarginal consumers. We observe the largest positive selection among low income consumers, who exhibit the largest frictions in enrollment. Finally, we estimate the implied value of the letter intervention to be $25 to $53 per month in subsidy dollars. These results suggest that frictions may partially explain low take-up for marketplace insurance, and that interventions reducing them can improve enrollment and market risk in exchanges. (JEL C93, G22, G52, H75, I13)