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NATIONAL BUREAU OF ECONOMIC RESEARCH

NBER Working Papers by Anne Royalty

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Working Papers

July 2011Gauging the Generosity of Employer-Sponsored Insurance: Differences Between Households With and Without a Chronic Condition
with Jean M. Abraham, Thomas DeLeire: w17232
We develop an empirical method to assess the generosity of employer-sponsored insurance across groups within the U.S. population. A key feature of this method is its simplicity - it only requires data on out-of-pocket (OOP) health care spending and total health care spending and does not require detailed knowledge of health insurance benefit design. We apply our method to assess whether households with a chronically ill member have more or less generous insurance relative to households with no chronically ill members. We find that the chronically ill have less generous insurance coverage than the non-chronically ill. Additional analyses suggest that the reason for this less generous coverage is not that households with a chronically ill member are in different, less generous plans, on av...
October 2009Moral Hazard Matters: Measuring Relative Rates of Underinsurance Using Threshold Measures
with Jean Marie Abraham, Thomas DeLeire: w15410
This paper illustrates the impact of moral hazard for estimating relative rates of underinsurance and to present an adjustment method to correct for this source of bias. Individuals or households are often classified as underinsured if out-of-pocket spending on medical care relative to income exceeds some threshold. We show that, without adjustment, this common threshold measure of underinsurance will underestimate the number with low levels of insurance coverage due to moral hazard. We propose an adjustment method and apply it to the specific case of estimating the difference in rates of underinsurance among small- versus large-firm workers with full-year, employer-sponsored insurance. Using data from the 2005 Medical Expenditure Panel Survey, we find that after applying the adjustment,...

Published: Abraham, Jean Marie, Thomas DeLeire, and Anne Bees on Royalty . (2010). “Moral Hazard Matters: Measuring Relative Rates of Underinsurance Using Threshold Measures” Health Services Research 45(3): 806 - 824.

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