TABLE 2.
Key Parameters and Issues for Modeling Health Insurance Expansions
| Parameter | Key Issues | Selected Citations |
|---|---|---|
| Baseline | ||
| Number of Uninsured Persons | Disagreement among data sources; modeling the characteristics of the uninsured | Dubay and Kenney 2000; Lewis, Ellwood, and Czajka 1998 |
| Premiums Paid by Consumers | Imputation of prices; prices of policies declined; price variation with health status | Blumberg and Nichols 2000; Curtis et al. 1999; Selden and Moeller 2000; Swartz and Garnick 1999; Zabinski et al. 1999 |
| Eligibility for Existing Public Health Insurance Programs | Lack of data for many eligibility criteria (e.g., assets); eligibility changes due to behavioral responses | Blumberg and Nichols 2000; Daponte, Sanders, and Taylor 1998 |
| Price Responsivenessa | ||
| Elasticity/Take-up | Reporting methods across different approaches; −0.4 to −0.6 elasticity | Feder, Uccello, and O'Brien 1999; Gruber 2000; Gruber and Poterba 1994; Holahan, Uccello, and Feder 1999; Royalty 2000 |
| Heterogeneity: Does Price Responsiveness Vary with Other Characteristics? | Variation by income: does responsiveness rise or fall? Variation by health status | Marquis and Long 1995; Monheit and Schur 1988; Pauly and Herring 2002; RWJF 2000 |
| Crowd-out: Do People with Existing Employer-Sponsored Coverage Also Respond to New Programs? | Substitutability of different programs | Cutler and Gruber 1996; Dubay and Kenney 1996; Thorpe and Florence 1998 |
| Nonprice Factors That Encourage or Deter Participation | ||
| Stigma | Lack of quantitative data | Remler and Glied, 2003 |
| Family Decisions | Spousal decisions; desire for “family unification” | Bilheimer and Reischauer 1995 |
| Employer's Behavior | ||
| Employer's Decision to Offer Health Insurance | Variation by firm size: offer elasticities, −0.6 to −1.8 for small firms and 0 to −0.2 for large firms | Blumberg and Nichols 2000; Feldman et al. 1989; Gruber and Lettau 2000; Marquis and Long 1995; Stabile 2002 |
| Employer's Contribution (share of premium paid by employer) | Estimating price responsiveness; variation by firm size | Dranove, Spier, and Baker 2000 |
| Incidence (degree to which wages fall owing to employer's health insurance costs) | Completeness; time scale | Gruber 1994; Sheiner 1999 |
Note:
a
Price and nonprice responsiveness include parameters that help predict how many people eligible for an insurance program or a particular set of benefits will actually avail themselves of it.