劳动力市场与医疗保险体系的互动：雇主提供、个人与公共保险

中文摘要

我们构建并估计了一个包含异质性地方市场、家庭和企业的均衡模型，着重考察健康保险体系各组成部分——雇主提供的健康保险（ESHI）、个人健康保险（HIX）和医疗补助（Medicaid）——之间的相互关系，以及它们与劳动力市场的关系。我们利用各州之间的差异以及《平价医疗法案》实施前后的变化来估计该模型。我们考察了在 ESHI 与 HIX 之间进行交叉补贴的反事实政策，其中包括作为特例的纯粹 ESHI-HIX 风险共担。我们发现，此类政策将提高家庭福利和产出，降低政府支出，并且在医疗补助扩展的情况下会更有效。

Abstract

We develop and estimate an equilibrium model with heterogeneous local markets, households, and firms, highlighting the interrelationship between various components of the health insurance system—employer-sponsored health insurance (ESHI), individual health insurance (HIX), and Medicaid—and their relationship with the labor market. We estimate the model exploiting variation across states and before and after the Affordable Care Act. We consider counterfactual policies that cross subsidize between ESHI and HIX, including pure ESHI-HIX risk pooling as a special case. We find that such policies would increase household welfare and output and decrease government expenditure and would be more effective with Medicaid expansion.