TY  - JOUR
AU  - Heiss,Florian
AU  - McFadden,Daniel
AU  - Winter,Joachim
TI  - Regulation of private health insurance markets: Lessons from enrollment, plan type choice, and adverse selection in Medicare Part D
JF  - National Bureau of Economic Research Working Paper Series
VL  - No. 15392
PY  - 2009
Y2  - October 2009
UR  - http://www.nber.org/papers/w15392
L1  - http://www.nber.org/papers/w15392.pdf
N1  - Author contact info:
Florian Heiss
University of Duesseldorf  
LS Statistics and Econometrics
Universitaetsstrasse 1, Geb. 24.31
40225  Düsseldorf 
Germany
E-Mail:  florian.heiss@hhu.de

Daniel L. McFadden
University of California, Berkeley
Department of Economics
549 Evans Hall #3880
Berkeley, CA 94720-3880
Tel: 510/643-8428
Fax: 510/642-0638
E-Mail: mcfadden@econ.berkeley.edu

Joachim Winter
Department of Economics
LMU
Ludwigstr. 28 (RG)
D-80539 Munich
Germany
E-Mail: winter@lmu.de
AB  - We study the Medicare Part D prescription drug insurance program as a bellwether for designs of private, non-mandatory health insurance markets that control adverse selection and assure adequate access and coverage.  We model Part D enrollment and plan choice assuming a discrete dynamic decision process that maximizes life-cycle expected utility, and perform counterfactual policy simulations of the effect of market design on participation and plan viability.  Our model correctly predicts high Part D enrollment rates among the currently healthy, but also strong adverse selection in choice of level of coverage.  We analyze alternative designs that preserve plan variety.
ER  -