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The Impact of Policy Incentives on Long-Term Care Insurance and Medicaid Costs: Does Underwriting Matter?
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- Author(s): Cornell, Portia Y.; Grabowski, David C.
- Source:
Health Services Research; Oct2018, Vol. 53 Issue 5, p3728-3749, 22p, 17 Charts, 1 Graph, 1 Map- Subject Terms:
LONG-term care insurance; MEDICAID costs; HEALTH insurance; INSURANCE; INSURANCE companies; HEALTH insurance costs; ECONOMIC impact; MEDICAID; HEALTH policy; LONG-term health care; PRIVATE sector; COMPARATIVE studies; DISCRIMINATION in insurance; RESEARCH methodology; MEDICAL cooperation; RESEARCH; RESEARCH funding; TAXATION; EVALUATION research; STATISTICAL models; STATE health plans; IMPACT of Event Scale; ECONOMICS - Source:
- Additional Information
- Subject Terms:
- Abstract:
Objective: To test whether underwriting modifies the effect of state-based incentives on individuals' purchase of long-term care insurance.Data Source: Health and Retirement Study (HRS), 1996-2012.Study Design: We estimated difference-in-difference regression models with an interaction of state policy indicators with individuals' probabilities of being approved for long-term care insurance.Data Extraction: We imputed probabilities of underwriting approval for respondents in the HRS using a model developed with underwriting decisions from two U.S. insurance firms. We measured the elasticity response to long-term care insurance price using changes in simulated after-tax price as an instrumental variable for premium price.Principal Findings: Tax incentives and Partnership programs increased insurance purchase by 3.62 percentage points and 1.8 percentage points, respectively, among those with the lowest risk (highest approval probability). Neither had any statistically significant effects among the highest risk individuals.Conclusions: We show that ignoring the effects of underwriting may lead to biased estimates of the potential state budget savings of long-term care insurance tax incentives. If the private market is to play a role in financing long-term care, policies need to address the underlying adverse selection problems. [ABSTRACT FROM AUTHOR] - Abstract: Copyright of Health Services Research is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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