nep-ias New Economics Papers
on Insurance Economics
Issue of 2015‒04‒02
sixteen papers chosen by
Soumitra K. Mallick
Indian Institute of Social Welfare and Business Management

  1. Congressionally Mandated Evaluation of the Children's Health Insurance Program: Texas Case Study By Cara Orfield Jung Y. Kim
  2. Affordability of National Flood Insurance Program Premiums—Report 1 By Allen L. Schirm; Committee Member Others
  3. Congressionally Mandated Evaluation of the Children's Health Insurance Program: A Case Study of Utah's CHIP Program By Ian Hill; Brigette Courtot; Margaret Wilkinson
  4. Narrow Framing and Long-Term Care Insurance By Daniel Gottlieb; Olivia S. Mitchell
  5. Crop Insurance in Iowa By Plastina, Alejandro; Hart, Chad E.
  6. TURKEY ON THE WAY OF UNIVERSAL HEALTH COVERAGE THROUGH THE HEALTH TRANSFORMATION PROGRAM (2003-13) By Jesse Bump; Susan Sparkes; Mehtap Tatar; Yusuf Celik; Meltem Aran; Claudia Rokx
  7. CHIPRA Evaluation of the Children's Health Insurance Program: Cross Cutting Report on Findings from Ten State Case Studies By Ian Hill; Sheila Hoag; Sarah Benatar; Cara Orfield; Embry Howell; Victoria Peebles; Brigette Courtot; Margaret Wilkinson
  8. Integration of Medicare and Medicaid for Dually Eligible Beneficiaries: State Efforts Inside and Outside Demonstration Authority By James M. Verdier
  9. Earnings, disposable income, and consumption of allowed and rejected disability insurcance applicants By Andreas Ravndal Kostøl; Magne Mogstad
  10. Anatomy of a Slow-Motion Health Insurance Death Spiral By Frech, Ted E; Smith, Michael P
  11. Development of Propositions on Options of Reforming of Pension System of Russian Federation Taking into Account Increasing of Reliability and Efficiency of Using of Cumulative Component By Dmitriev, Mikhail
  12. Using the Life Satisfaction Approach to Value Daylight Savings Time Transitions: Evidence from Britain and Germany By Daniel Kuehnle; Christoph Wunder
  13. Does Medicaid Coverage for Pregnant Women Affect Prenatal Health Behaviors? By Dhaval M. Dave; Robert Kaestner; George L. Wehby
  14. State Variation in the Delivery of Comprehensive Services for Medicaid Beneficiaries with Schizophrenia and Bipolar Disorder By Jonathan D. Brown; Allison Barrett; Kerianne Hourihan; Emily Caffery; Henry T. Ireys
  15. Use of Quality Measures for Medicaid Behavioral Health Services by State Agencies: Implications for Health Care Reform By Julie Seibert; Suzanne Fields; Catherine Anne Fullerton; Tami L. Mark; Sabrina Malkani; Christine Walsh; Emily Ehrlich; Melina Imshaug; Maryam Tabrizi
  16. The different impact of conventional interest rates on Islamic stock market, Islamic banking and Islamic insurance: evidence from Malaysia By Othman, Arshad Nuval; Masih, Mansur

  1. By: Cara Orfield Jung Y. Kim
    Keywords: CHIP, Congressionally Mandated Evaluation, Children's Health Insurance Program, Texas Case Study
    JEL: I
    Date: 2013–04–11
  2. By: Allen L. Schirm; Committee Member Others
    Abstract: The Biggert-Waters Act of 2012 was designed to move the National Flood Insurance Program (NFIP) toward risk-based premiums that better reflect expected losses from floods at insured properties. The result of this legislation would have been premium increases for some households which had been paying less than NFIP risk-based premiums, and increased risk-based premiums for all policy holders.
    Keywords: National Flood Insurance Program Premiums
    JEL: C
    Date: 2015–03–30
  3. By: Ian Hill; Brigette Courtot; Margaret Wilkinson
    Keywords: CHIP, Congressionally Mandated Evaluation, Children's Health Insurance Program, Case Study of Utah's CHIP Program
    JEL: I
    Date: 2013–04–30
  4. By: Daniel Gottlieb; Olivia S. Mitchell
    Abstract: We propose a model of narrow framing in insurance and test it using data from a new module we designed and fielded in the Health and Retirement Study. We show that respondents subject to narrow framing are substantially less likely to buy long-term care insurance than average. This effect is distinct from, and much larger than, the effects of risk aversion or adverse selection, and it offers a new explanation for why people underinsure their later-life care needs.
    JEL: D03 G22 I13
    Date: 2015–03
  5. By: Plastina, Alejandro; Hart, Chad E.
    Date: 2014–12–10
  6. By: Jesse Bump; Susan Sparkes; Mehtap Tatar; Yusuf Celik; Meltem Aran; Claudia Rokx
    Abstract: Beginning in 2003, Turkey initiated a series of reforms under the Health Transformation Program (HTP) that over the past decade have led to the achievement of universal health coverage (UHC). The progress of Turkey?s health system has few ? if any ? parallels in scope and speed. Before the reforms, Turkey?s aggregate health indicators lagged behind those of OECD member states and other middle-income countries. The health financing system was fragmented, with four separate insurance schemes and a ?Green Card? program for the poor, each with distinct benefits packages and access rules. Both the Ministry of Labor and Social Security and Ministry of Health (MoH) were providers and financiers of the health system, and four different ministries were directly involved in public health care delivery. Turkey?s reform efforts have impacted virtually all aspects of the country?s health system and have resulted in the rapid expansion of the proportion of the population covered and of the services to which they are entitled. At the same time, financial protection has improved. For example, (i) insurance coverage increased from 64 to 98 percent between 2002 and 2012; (ii) the share of pregnant women having four antenatal care visits increased from 54 to 82 percent between 2003 and 2010; and (iii) citizen satisfaction with health services increased from 39.5 to 75.9 percent between 2003 and 2011. Despite dramatic improvements there is still space for Turkey to continue to improve its citizens? health outcomes, and challenges lie ahead for improving services beyond primary care. The main criticism to reform has so far come from health sector workers; the future sustainability of reform will rely not only on continued fiscal support to the health sector but also the maintanence of service provider satisfaction.
    Keywords: access to health care, access to health care services, access to health services, administrative control, allocative efficiency, antenatal care, Capita Health Expenditure ... See More + child mortality, Childbirth, citizen, citizens, communicable diseases, deaths, Debt, delivery system, demand for health, demand for health services, doctors, Economic growth, economic resources, emergency vehicles, Employment, expenditures, financial protection, financing of health care, focus group discussions, fragmented financing system, General practitioners, Health Administration, Health Affairs, health care, Health Care Costs, health care delivery, health care expenditures, health care facilities, health care providers, health care sector, health care services, health care system, health centers, HEALTH COVERAGE, Health Data, health delivery, health delivery system, Health Expenditure, Health expenditure growth, Health Expenditure per capita, health expenditures, Health facilities, health finance, Health Financing, health financing system, health indicators, health infrastructure, health insurance, health insurance scheme, Health Insurance System, Health Organization, health outcomes, Health Planning, Health Policy, health posts, health professionals, Health Project, health reform, health reforms, health risks, health sector, health sector reform, health sector workers, health services, health spending, Health status, health status indicators, health supply, health system, Health System Efficiency, Health Systems, Health Systems in Transition, health workers, health workforce, Health-Care, Health-Care System, Health-Financing, Healthcare Spending, hospital autonomy, hospital beds, Hospital management, Hospital Sector, hospitals, HR, human development, human resources, illness, Immunization, income, income countries, income households, individual health, induced demand, infant, infant mortality, infant mortality rate, inservice training, insurance, insurance coverage, insurance schemes, integration, labor market, level of health spending, life =expectancy, life expectancy, life expectancy at birth, live births, local authorities, maternal health, maternal health services, medical centers, Medical Policy, medical school, medical specialties, medicines, Midwives, Ministry of Health, morbidity, mortality, National Health, National Health Insurance, National Health Policy, Newborn Health, nurses, Nutrition, old system, outpatient services, paradigm shift, paramedics, parliamentary seats, party platform, patient, patient care, Patient Cost, patient satisfaction, patients, pharmaceutical expenditures, pharmacists, pharmacy, physician, physicians, pocket payments, policy change, policy decisions, policy goals, Policy Research, political power, political turmoil, popular support, Pregnancy, pregnant women, prescription drugs, preventive health services, primary care, primary health care, primary health care facilities, private insurance, private pharmacies, private sector, private sectors, professional associations, progress, provision of health care, Public Expenditure, Public Health, public health care, public health expenditures, public health system, Public Hospital, Public Hospitals, public providers, public sector, public service, public support, purchaser-provider split, purchasing power, purchasing power parity, quality assurance, quality of care, quality of services, rural areas, scientific evidence, series of meetings, service delivery, service provider, service provision, service quality, service utilization, Social Insurance, Social Policy, Social Security, social security schemes, socioeconomic development, socioeconomic status, State Planning, supply of health care, Sustainable Development, Trade Unions, Under-five mortality, urban centers, workers
    Date: 2014–09
  7. By: Ian Hill; Sheila Hoag; Sarah Benatar; Cara Orfield; Embry Howell; Victoria Peebles; Brigette Courtot; Margaret Wilkinson
    Keywords: CHIPRA Evaluation , Children's Health Insurance Program, Cross Cutting Report on Findings from Ten State Case Studies
    JEL: I
    Date: 2013–05–31
  8. By: James M. Verdier
    Keywords: SNP, Special Needs Plan, Medicare, Medicaid, Dual Eligibles
    JEL: I
    Date: 2015–03–30
  9. By: Andreas Ravndal Kostøl; Magne Mogstad (Statistics Norway)
    Abstract: Two key questions in thinking about the size and growth of the disability insurance program are to what extent it discourages work, and how valuable the insurance is to individuals and families. These questions motivate our paper. We begin by describing the earnings, disposable income and consumption of awarded and rejected DI applicants, before and after the disability onset and the allowance decision. Next, we discuss how these descriptive results can be interpreted through the lens of alternative empirical approaches. Our analysis uses a Norwegian population panel data set with detailed information about every individual and household.
    Keywords: disability insurance; labor supply; benefit substitution; disposable income
    JEL: I38 J62 H53
    Date: 2015–03
  10. By: Frech, Ted E; Smith, Michael P
    Abstract: Adverse selection death spirals in health insurance are dramatic, and so far, exotic economic events. The possibility of death spirals has garnered recent policy and popular attention because the pricing regulations in the Affordable Care Act of 2010 make health plans more vulnerable to them (though some other aspects of the ACA limit them). Most death spirals tracked in the literature have involved selection against a group health plan that was dropped quickly by the employer. In this paper, we empirically document a death spiral in individual health insurance that was apparently triggered by a block closure in 1981 and developed slowly because the insurer partially subsidized the block. Indeed, we show that premiums rose dramatically from around the time of the block closure to at least 2009 (the last year of available data). By 2009, some, but very few policyholders remained in the block and premiums were roughly seven times that of a yardstick we developed. The history of this slow-moving event is directly relevant to current policy discussions because of both adverse selection in general and the particular problems induced by closing a block.
    Keywords: Social and Behavioral Sciences, Adverse Selection, Death Spiral, Health Insurance, Affordable Care Act, Asymmetric Information, Community Rating, Underwriting
    Date: 2015–01–01
  11. By: Dmitriev, Mikhail (Russian Presidential Academy of National Economy and Public Administration (RANEPA))
    Abstract: Foreign experience shows that, as a rule, contributions for compulsory pension insurance paid by both employees and employers. In Russia, the premiums are paid entirely by employers. Under the current system of administration of insurance contributions for compulsory pension insurance there is a conflict between the tax and insurance essence of this payment.
    Keywords: retirement, pension, insurance, Russia, tax
    Date: 2014–06
  12. By: Daniel Kuehnle; Christoph Wunder
    Abstract: Daylight savings time (DST) represents a public good with costs and benefits. We provide the first comprehensive examination of the welfare effects of the spring and autumn transitions for the UK and Germany. Using individual-level data and a regression discontinuity design, we estimate the effect of the transitions on life satisfaction. Our results show that individuals in both the UK and Germany experience deteriorations in life satisfaction in the first week after the spring transition. We find no effect of the autumn transition. We attribute the negative effect of the spring transition to the reduction in the time endowment and the process of adjusting to the disruption in circadian rhythms. The effects are particularly strong for individuals with young children in the household. We conclude that the higher the shadow price of time, the more difficult is adjustment. Presumably, an increase in flexibility to reallocate time could reduce the welfare loss for individuals with binding time constraints.
    Keywords: Daylight savings time, life satisfaction, regression discontinuity, UK, Germany
    JEL: H41 I31
    Date: 2015
  13. By: Dhaval M. Dave; Robert Kaestner; George L. Wehby
    Abstract: Despite plausible mechanisms, little research has evaluated potential changes in health behaviors as a result of the Medicaid expansions of the 1980s and 1990s for pregnant women. Accordingly, we provide the first national study of the effects of Medicaid on health behaviors for pregnant women. We exploit exogenous variation from the Medicaid income eligibility expansions for pregnant women and children during late-1980s through mid-1990s to examine effects on several prenatal health behaviors and health outcomes using U.S. vital statistics data. We find that increases in Medicaid eligibility were associated with increases in smoking and decreases in weight gain during pregnancy. Raising Medicaid eligibility by 12 percentage-points increased rates of any prenatal smoking and smoking more than five cigarettes daily by 0.7-0.8 percentage point. Medicaid expansions were associated with a reduction in pregnancy weight-gain by about 0.6%. These effects diminish at higher levels of eligibility, which is consistent with crowd-out from private to public insurance. Importantly, our evidence is consistent with ex-ante moral hazard although income effects are also at play. The worsening of health behaviors may partly explain why Medicaid expansions have not been associated with substantial improvement in infant health.
    JEL: D1 D9 I12 I13 I18
    Date: 2015–03
  14. By: Jonathan D. Brown; Allison Barrett; Kerianne Hourihan; Emily Caffery; Henry T. Ireys
    Abstract: Medicaid beneficiaries with schizophrenia and bipolar disorder require a range of services and supports. This descriptive study used 2007 Medicaid claims data from 21 states and the District of Columbia to examine the extent to which this population received guideline-concordant medications, medication monitoring, outpatient mental health care, and preventive physical health care. More than 80 % of beneficiaries in each state filled at least one prescription for a guideline-concordant medication during the year but, on average, only 57 % of those with schizophrenia and 45 % of those with bipolar disorder maintained a continuous supply of medications. Roughly 25 % did not have an outpatient mental health visit during the year (excluding case management and some other services); in some states more than half did not have such a visit. Only 11 % of beneficiaries received a physical health examination or health behavior counseling when claims codes were used to identify these services rather than all primary care physician visits. Less than 5 % of beneficiaries maintained their supply of medications, received medication monitoring and had an outpatient mental health visit, physical health examination or received health behavior counseling during the year. Although these rates of service utilization are likely conservative and the data predate recent efforts to integrate care, the findings underscore the need for quality improvement efforts targeted to this population and may provide a baseline for monitoring progress.
    Keywords: State Variation, Comprehensive Services, Medicaid Beneficiaries, Schizophrenia, Bipolar Disorder
    JEL: I
    Date: 2015–03–19
  15. By: Julie Seibert; Suzanne Fields; Catherine Anne Fullerton; Tami L. Mark; Sabrina Malkani; Christine Walsh; Emily Ehrlich; Melina Imshaug; Maryam Tabrizi
    Abstract: The structure-process-outcome quality framework espoused by Donabedian provides a conceptual way to examine and prioritize behavioral health quality measures used by states. This report presents an environmental scan of the quality measures and satisfaction surveys that state Medicaid managed care and behavioral health agencies used prior to Medicaid expansion in 2014.
    Keywords: Quality Measures, Medicaid, Behavioral Health, State Agencies, Health Care Reform
    JEL: I
    Date: 2015–03–01
  16. By: Othman, Arshad Nuval; Masih, Mansur
    Abstract: This paper seeks to close the gap of the lack of empirical evidence surrounding the different impact of conventional interest rates on Islamic finance components – Islamic stock markets, Islamic banking and Islamic insurance (called takaful). Such evidence remains imperative in order for the Islamic finance system to formulate effective countermeasures against changes in conventional interest rates. Using Malaysia as a case in point, this paper employs time-series techniques to establish long-run and causal relationships among an Islamic stock market, an Islamic bank stock, an Islamic insurance company stock, the overnight conventional interbank money market rate and several control variables. Results suggest the distinct interaction of each Islamic finance component with conventional interest rates – the positive long-run relationship and bidirectional causality between Islamic stock markets and conventional interest rates, the negative long-run relationship and bidirectional causality between Islamic banking and conventional interest rates, and the negative long-run relationship and unidirectional causality from Islamic insurance to conventional interest rates. Policymakers should remain concerned primarily with the impact of conventional interest rates on Islamic stock markets and Islamic banking due to the negative income gap of Islamic banks which expose the Islamic finance system to higher financial risk. Thus, policymakers should incentivize Islamic banks to convert the negative income gap into a positive income gap through imposing higher capital requirements on fixed-rate nominal assets.
    Keywords: Islamic stock market, Islamic banking, Islamic insurance, interest rates, Granger-causality
    JEL: C22 C58 E44
    Date: 2014–07–10

This nep-ias issue is ©2015 by Soumitra K. Mallick. It is provided as is without any express or implied warranty. It may be freely redistributed in whole or in part for any purpose. If distributed in part, please include this notice.
General information on the NEP project can be found at For comments please write to the director of NEP, Marco Novarese at <>. Put “NEP” in the subject, otherwise your mail may be rejected.
NEP’s infrastructure is sponsored by the School of Economics and Finance of Massey University in New Zealand.