Private Insurance/Exchanges

The main source of health insurance in the US, primarily through employers. The Affordable Care Act established health insurance exchanges (marketplaces) for the individual and small group market.

Household Labor Search, Spousal Insurance, and Health Care Reform

Oct. 1, 2019

Hanming Fang, Andrew J. Shephard

Abstract [from journal]

Health insurance in the United States for the working age population has traditionally been provided in the form of employer-sponsored health insurance (ESHI). If employers offered ESHI to their employees, they also typically extended coverage to their spouse and dependents. Provisions in the Affordable Care Act (ACA) significantly alter the incentive for firms to offer insurance to the spouses of employees. We evaluate the long-run impact of ACA on firms’ insurance offerings and on household outcomes by developing and estimating an equilibrium job search...

The Burden of Health Care Costs for Working Families

Issue Brief
Apr. 1, 2019

Growing concern about the affordability of health care and the cost burden imposed on working families frequently appears in public debate about the next phase of health care reform. In this second brief of our affordability series, Penn LDI and United States of Care adapt a national-level affordability index to provide state-level data on the cost burden faced by working families who have employer-sponsored insurance (ESI). We examine how this burden varies across states, and how it has changed within states from 2010 to 2016.

Consumers' Responses to Surprise Medical Bills in Elective Situations

Research Brief
Mar. 4, 2019

A surprise medical bill is a bill from an out-of-network provider that was not expected by or not chosen by the patient.To see whether consumers are more likely to switch hospitals after receiving a surprise bill, Benjamin Chartock and Sarah Schutz, and their co-author Christopher Garmon, analyzed nationwide employer-sponsored health insurance claims for labor and delivery services. Mothers who received a surprise out-of-network bill for their first delivery had 13% greater odds of switching hospitals for their second delivery compared to those who did not get a surprise bill.

How Do Consumers Respond to Surprise Medical Bills?

Mar. 4, 2019

Today, you often hear stories of patients who visit an in-network hospital and still receive a large medical bill because one or more providers involved in their care was out-of-network. Although this phenomenon of “surprise billing” has become common, no research has examined how consumers respond to surprise bills and alter their health-seeking behavior.

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