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American Economic Review Vol. 108 No. 8 2018

Do Larger Health Insurance Subsidies Benefit Patients or Producers? Evidence from Medicare Advantage

Marika Cabral1; Michael Geruso1; Neale Mahoney2

1 Department of Economics, The University of Texas at Austin, 1 University Station, Austin, TX 78712 (email: ) · 2 University of Chicago Booth School of Business, 5807 South Woodlawn Avenue, Chicago, IL 60637 (email: )

open access

Abstract

A central question in the debate over privatized Medicare is whether increased government payments to private Medicare Advantage (MA) plans generate lower premiums for consumers or higher profits for producers. Using difference‑in‑differences variation brought about by a sharp legislative change, we find that MA insurers pass through 45 percent of increased payments in lower premiums and an additional 9 percent in more generous benefits. We show that advantageous selection into MA cannot explain this incomplete pass‑through. Instead, our evidence suggests that market power is important, with premium pass‑through rates of 13 percent in the least competitive markets and 74 percent in the most competitive.

DOI
10.1257/aer.20151362
Volume
108
Issue
8
Pages
2048-2087
Language
en
Sources
bibtex:phds-export.bib openalex crossref

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