The Effect of the Number of Plans on Inertia and Adverse Selection: Evidence from the ACA Público
Cohen, Samuel (Spring 2023)
Abstract
In this paper I estimate the effect the number of choices has on both adverse selection and inertia within a
market. Specifically, I am interested in whether choice overload can cause a decrease in adverse selection
and increase inertia. To do this I utilize data from the ACA exchanges at the national level for adverse
selection and inertia. I found that it is likely that an increase in plans correlates with an increase in adverse
selection as consumers can make informed decisions from a wider array of choices. Inertia also decreases
with an increase in choices. My model also estimates that at a high number of plans, both relationships
reverse as choice overload takes effect.
Table of Contents
1 Introduction 2
1.1 Motivation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
1.2 Background on the Affordable Care Act and the Exchanges . . . . . . . . . . . . . . . . . . . . 2
1.3 Choice Overload . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
1.4 Adverse Selection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
1.5 Inertia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
1.6 Contributions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
2 Methodology 5
2.1 Data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
2.2 Econometric Model for Adverse Selection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
2.3 Econometric Model for Inertia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
3 Results 8
3.1 Adverse Selection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
3.2 Inertia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
4 Conclusion 11
4.1 Limitations and Future Research . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
4.2 Discussion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
5 References 13
6 Appendix 14
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