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This paper investigates consumer inertia in health insurance markets,where adverse selection is a potential concern. We leverage a majorchange to insurance provision that occurred at a large firm toidentify substantial inertia, and develop and estimate a choice modelthat also quantifies risk preferences and ex ante health risk. We usethese estimates to study the impact of policies that nudge consumerstoward better decisions by reducing inertia. When aggregated,these improved individual-level choices substantially exacerbateadverse selection in our setting, leading to an overall reduction inwelfare that doubles the existing welfare loss from adverse selection.