UC San Diego

This work examines consumer and producer responses to market dynamics resulting from various policy changes in the individual health insurance market under the Affordable Care Act (ACA). Chapter 1 investigates dominated plan choice manifesting as inertia in California, finding that fewer than 40% of enrollees who should switch plans do so. Further, this chapter examines the relationship between these choice errors, publicly available enrollment assistance, and active plan choice. Chapter 2 delves into nationwide pricing dynamics that result in two pricing anomalies: dominated plan choice and free plans. I find robust evidence of dominated plan choice and suggestive evidence of inertia. Chapter 3 documents and analyzes changes to Essential Health Benefits, which serve as benefit mandates, and examines margins that insurance issuers adjust their plans in response to being bound by these mandates. These margins include changes to premiums and cost-sharing structure. I find that insurance issuers who are newly bound to these benefit mandates increase premiums by 2% per benefit relative to those who already provided them.