Screening in Contract Design: Evidence from the ACA Health Insurance Exchanges

A-Tier
Journal: American Economic Journal: Economic Policy
Year: 2019
Volume: 11
Issue: 2
Pages: 64-107

Score contribution per author:

1.341 = (α=2.01 / 3 authors) × 2.0x A-tier

α: calibrated so average coauthorship-adjusted count equals average raw count

Abstract

We study insurers' use of prescription drug formularies to screen consumers in the ACA Health Insurance exchanges. We begin by showing that exchange risk adjustment and reinsurance succeed in neutralizing selection incentives for most, but not all, consumer types. A minority of consumers, identifiable by demand for particular classes of prescription drugs, are predictably unprofitable. We then show that contract features relating to these drugs are distorted in a manner consistent with multidimensional screening. The empirical findings support a long theoretical literature examining how insurance contracts offered in equilibrium can fail to optimally trade off risk protection and moral hazard.

Technical Details

RePEc Handle
repec:aea:aejpol:v:11:y:2019:i:2:p:64-107
Journal Field
General
Author Count
3
Added to Database
2026-01-25