Department of Health Policy and Management, T.H. Chan School of Public Health, Harvard University, United States of America.
J Health Econ. 2023 Sep;91:102785. doi: 10.1016/j.jhealeco.2023.102785. Epub 2023 Aug 7.
I compare two pricing regulations that protect those with health conditions-"community rating," which requires insurers to charge uniform premiums, and "guaranteed renewal," which requires insurers to increase future premiums uniformly. Using individual-level Medigap data from 2006-2010, I compare individuals within 25 miles of borders between 3 community rating and 6 guaranteed renewal states. Relative to guaranteed renewal, community rating (with guaranteed issue) leads to a decrease in Medigap enrollment of 9.70 pp (29.7%), or 26.8-33.7% for low-spending conditions (diabetes, heart disease) and 21.9-29.9% for high-spending conditions (cancer, kidney disease); an increase in annual Medigap premiums of $276 (10.1%); a decrease in the likelihood of an earlier purchase of 7.99 pp (50.3%); and an increase in purchase delay of 1.08 years (17.0%).
我比较了两种保护健康状况人群的定价法规——“社区评级”，要求保险公司收取统一的保费，以及“保证续保”，要求保险公司统一提高未来保费。利用 2006 年至 2010 年的个人层面的医疗保险补充数据，我在 25 英里范围内比较了 3 个社区评级和 6 个保证续保州的个人。与保证续保相比，社区评级（保证承保）导致医疗保险补充参保人数减少 9.70 个百分点（29.7%），对于低支出情况（糖尿病、心脏病）减少 26.8%-33.7%，对于高支出情况（癌症、肾病）减少 21.9%-29.9%；医疗保险补充年保费增加 276 美元（10.1%）；提前购买的可能性降低 7.99 个百分点（50.3%）；购买延迟增加 1.08 年（17.0%）。
