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CHAPTER 1. BANKRUPTCY 27 least debtor-friendly laws is smaller in magnitude because most uninsured household have little wealth and are thus not exposed to substantially more financial risk under these laws. Achieving the same increase in coverage as implied by the Delaware laws would require a large premium subsidy. Too see this, I use the -0.084 take-up premium semi-elasticity for the uninsured estimated by the ?. 36 With this elasticity, inducing a 3.7 percentage points increase in coverage requires a premium subsidy of 44.0 (= 100 × (0.037/0.084)) percent. The effect does not seem to be driven by an endogenous response of either wealth or premiums. Assets are completely unresponsive to asset exemption laws. And while a log point increase in asset exemptions is associated with a (marginally significant) 7 percent decrease in insurance premiums, controlling for premiums does not impact the coefficient on seizable assets. This is consistent with findings in the literature that the demand for health insurance is highly premium inelastic. For example, with the -0.084 premium semi-elasticity discussed above, a 7 percent decrease in insurance premiums is projected to increase insurance coverage by only 0.6 (=-0.084 × -0.07) percentage points. 1.6 The Effect on Costs 1.6.1 Baseline Estimates Table 1.8 presents the baseline OLS and 2SLS estimates of the effect on costs. The sample includes all uninsured households with positive medical utilization. Standard errors are clustered at the state level in all specifications. In the OLS specification without controls (column 1), the elasticity of out-of-pocket payments with respect wildcard exemption. Households cannot exempt any home or vehicle equity in excess of the $500 wildcard. See Table 1.1 for details. 36 The ? estimate of -0.084 is identified off premium variation due to state-level community rating and premium compression regulations. The estimate is central to the small number of estimates in the literature. It is smaller than the estimate of ?, who use the introduction of a tax subsidy for insurance purchases by the self-employed, and is larger than the estimate from ?. See? for a review of estimates in the literature.
CHAPTER 1. BANKRUPTCY 28 to seizable assets is 0.56. Including controls for household demographics and utilization reduces this coefficient to 0.22 (column 2). Controlling for wealth has little incremental effect (column 3). The 2SLS estimates using the baseline instrument are shown in columns 4 to 6, adding controls in the same manner as columns 1 to 3. With controls, the 2SLS point estimates are slightly larger than the corresponding OLS specifications. In the preferred specification with controls for demographics and utilization (column 5), the elasticity of out-of-pocket payments with respect to seizable assets is 0.37. As before, controlling for wealth (column 6) has little effect. 1.6.2 Sensitivity Analysis Table 1.9 examines the sensitivity of these results to concerns about potential bias from endogenous asset exemptions. Column 1 adds controls for hospital and state characteristics. Because hospitals with different ownership structures may have different incentives and preferences for charity care, I include controls for the share of public and nonprofit hospitals in each state (private hospitals are the omitted category). I control for Disproportionate Share Hospital (DSH) payments per 1,000 residents as these may affect incentives to provide unpaid care, the presence of state charity care pools, and the number of Federally Qualified Health Centers per 100,000 people. The parameters of interest are virtually unchanged in these specifications and none of the covariates have coefficients that are statistically distinguishable from zero. Column 2 uses the instrument that isolates variation due to contemporaneous homestead exemptions and column 3 uses the instrument that isolates variation due to exemptions for non-homestead assets with no effect on the parameter of interest. Column 4 applies the instrument that isolates variation due to 1920 homestead exemptions. Using this source of variation addresses concerns that contemporaneous asset exemptions may be influenced by unobserved state-level factors such as the strength of the hospital lobby or state-level attitudes towards charity care. The estimates are very similar with this instrument.
Page 1 and 2: ESSAYS IN PUBLIC FINANCE AND INDUST
Page 3 and 4: I certify that I have read this dis
Page 5 and 6: insurance choice. Among other thing
Page 7 and 8: Acknowledgements I am deeply thankf
Page 9 and 10: Contents Preface iv Acknowledgement
Page 11 and 12: 2.5.3 The Value of Plan Choice ....
Page 13 and 14: List of Tables 1.1 Asset Exemption
Page 15 and 16: 4.9 First Week Contract Spending fo
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Page 19 and 20: CHAPTER 1. BANKRUPTCY 2 of the dead
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Chapter 3 Private Coverage and Publ
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CHAPTER 3. MEDIGAP 119 be of intere
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CHAPTER 3. MEDIGAP 121 hazard for i
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CHAPTER 3. MEDIGAP 123 have benefit
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CHAPTER 3. MEDIGAP 128 We use boots
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CHAPTER 3. MEDIGAP 130 of costs and
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CHAPTER 3. MEDIGAP 132 policy that
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CHAPTER 3. MEDIGAP 134 3.6.2 Causal
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CHAPTER 3. MEDIGAP 136 3.6.3 Robust
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CHAPTER 3. MEDIGAP 138 calculated u
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CHAPTER 3. MEDIGAP 140 (10000,11000
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CHAPTER 3. MEDIGAP 142 Table 3.2: S
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