Molly Frean

The Wharton School
University of Pennsylvania
3641 Locust Walk
Philadelphia, PA 19104
United States

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NBER Working Papers and Publications

October 2018Does High Cost-Sharing Slow the Long-term Growth Rate of Health Spending? Evidence from the States
with Mark Pauly: w25156
Multiple studies have shown that high-deductible health plans lower spending levels, however, less is known about whether such plans have an effect on spending growth. We begin with a model of the relationship between levels of insurance coverage and both spending levels and spending growth, highlighting the role of new technology adoption in the latter. Next, we leverage cross-sectional variation in private deductibles across states (and over time) to estimate whether areas with relatively higher deductibles experience lower spending growth. We use publicly available data from the Centers for Medicare and Medicaid Services and the Agency for Healthcare Research and Quality from 2002-2016, a period during which deductibles among privately insured employees more than tripled in magnitude an...
April 2016Premium Subsidies, the Mandate, and Medicaid Expansion: Coverage Effects of the Affordable Care Act
with Jonathan Gruber, Benjamin D. Sommers: w22213
Using premium subsidies for private coverage, an individual mandate, and Medicaid expansion, the Affordable Care Act (ACA) has increased insurance coverage. We provide the first comprehensive assessment of these provisions’ effects, using the 2012-2015 American Community Survey and a triple-difference estimation strategy that exploits variation by income, geography, and time. Overall, our model explains 60% of the coverage gains in 2014-2015. We find that coverage was moderately responsive to price subsidies, with larger gains in state-based insurance exchanges than the federal exchange. The individual mandate’s exemptions and penalties had little impact on coverage rates. The law increased Medicaid among individuals gaining eligibility under the ACA and among previously-eligible populatio...

Published: Molly Frean & Jonathan Gruber & Benjamin D. Sommers, 2017. "Premium subsidies, the mandate, and Medicaid expansion: Coverage effects of the Affordable Care Act," Journal of Health Economics, vol 53, pages 72-86. citation courtesy of

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