nep-ias New Economics Papers
on Insurance Economics
Issue of 2020‒10‒12
sixteen papers chosen by
Soumitra K. Mallick
Indian Institute of Social Welfare and Business Management

  1. Investigating the Effect of Health Insurance in the COVID-19 Pandemic By Rajashri Chakrabarti; Lindsay Meyerson; William Nober; Maxim L. Pinkovskiy
  2. The ACA Medicaid Expansions and Employment of Adults With Disabilities By Purvi Sevak; Jody Schimmel Hyde
  3. Business Cycle Sensitivity of Statutory Health Insurance: Evidence from the Czech Republic By Petra Landovska
  4. Building climate resilience through social protection in Brazil: the Garantia Safra public climate risk insurance programme By Elena Kühne
  5. Impact of State Children’s Health Insurance Program on Fertility of Immigrant Women By Kabir Dasgupta; Keshar Ghimire; Alexander Plum
  6. Crowding out or crowding in? The influence of subsidised crop insurance on climate change adaptation By Doidge, Mary
  7. Work Disability after Motherhood and How Paternity Leave Can Help By Fontenay, Sébastien; Tojerow, Ilan
  8. Redrawing of a Housing Market: Insurance Payouts and Housing Market Recovery in the Wake of the Christchurch Earthquake of 2011 By Cuong Nguyen; Ilan Noy; Dag Einar Sommervoll; Fang Yao
  9. A comparative analysis of the effects of unemployment insurance savings accounts on the labour market By Ana Luiza Neves de Holanda Barbosa; Miguel Nathan Foguel; Charlotte Bilo
  10. Uptake of Medicare Behavioral Health Integration Billing Codes in 2017 and 2018 By Jonathan Brown; Carol Urato; Precious Ogbuefi
  11. A pandemic business interruption insurance By Alexis Louaas; Pierre Picard
  12. Self-insurance and Non-concave Distortion Risk Measures By Sarah Bensalem
  13. Lives Saved during Economic Downturns: Evidence from Australia By Atalay, Kadir; Edwards, Rebecca; Schurer, Stefanie; Ubilava, David
  14. Evaluation of the Health Care Innovation Awards, Round 2: Final Report By Boyd Gilman; Danielle Whicher; Randall Brown; Nancy McCall; Stacy Dale; Laurie Felland; Robert Schmitz; John Schurrer; Lauren Vollmer Forrow; Mark Flick; Jim Derzon; Rizwaan Lakhani
  15. Evaluation of the Direct Certification with Medicaid for Free and Reduced-Price Meals (DCM-F/RP) Demonstrations, Year 2 (Summary) By Lara Hulsey; Andrew Gothro; Joshua Leftin; Liana Washburn; Brian Estes; Kathy Wroblewska; Hilary Wagner; Amanda Lee; Claire Smither Wulsin; Kelsey Chesnut
  16. COVID-19 and social protection in South Asia: Afghanistan By Beatriz Burattini

  1. By: Rajashri Chakrabarti; Lindsay Meyerson; William Nober; Maxim L. Pinkovskiy
    Abstract: Does health insurance improve health? This question, while apparently a tautology, has been the subject of considerable economic debate. In light of the COVID-19 pandemic, it has acquired a greater urgency as the lack of universal health insurance has been cited as a cause of the profound racial gap in coronavirus cases, and as a cause of U.S. difficulties in managing the pandemic more generally. However, estimating the effect of health insurance is difficult because it is (generally) not assigned at random. In this post, we approach this question in a novel way by exploiting a natural experiment—the adoption of the Affordable Care Act (ACA) Medicaid expansion by some states but not others—to tease out the causal effect of a type of health insurance on COVID-19 intensity.
    Keywords: COVID-19; Affordable Care Act; regression discontinuity
    JEL: I18 I13
    Date: 2020–09–25
  2. By: Purvi Sevak; Jody Schimmel Hyde
    Abstract: This article investigates whether states that expanded Medicaid coverage through the ACA in 2014—the first year expansion was possible and the year that most states opted to expand—experienced differential changes in employment rate of adults with disabilities relative to states that did not expand.
    Keywords: employment, Medicaid, health insurance, Affordable Care Act
  3. By: Petra Landovska (Institute of Economic Studies, Faculty of Social Sciences, Charles University, Opletalova 26, 110 00, Prague, Czech Republic)
    Abstract: Since the Czech healthcare system financing is based on Statutory Health Insurance scheme, it relies heavily on wage-based contributions from employers and employees and thus may be prone to business cycle fluctuations. This turned out to be a problem after the 2008 financialcrisis when the government had to issue loans to the insurance funds in order to cover the loss of revenue from the economically active population. This paper examines how the insurance funds' revenues react to economic downturns and expansions, and whether the effect is visible immediately or with a lag. The data from Ministry of Health, Czech Republic, are used, as well as several macroeconomic variables representing the business cycle. The static and lagged regression models on log differenced data are employed throughout the analysis. Significant pro-cyclicality in total health insurance funds' revenues and contributions from employers/employees is found, with the lagged effect being slightly stronger. On the contrary, contributions from state on behalf of economically inactive people do not display a significant relationship with business cycle. These results imply the need to increase state contributions during economic downturns in order to compensate for the loss of health insurance funds' revenues from economically active individuals.
    Keywords: health system financing, sensitivity analysis, business cycle, Czech Republic, social health insurance
    JEL: E32 G28 I13 I18
    Date: 2020–09
  4. By: Elena Kühne (IPC-IG)
    Abstract: This One Pager examines social protection's role in building climate resilience based on evidence from the Garantia Safra programme, a public index-based climate risk insurance scheme in Brazil.
    Keywords: protection; resilience; climate change adaptation; disaster risk management; climate risk insurance; smallholders; rural development; Garantia Safra
    Date: 2020–07
  5. By: Kabir Dasgupta (NZ Work Research Institute, Faculty of Business, Economics and Law at AUT University); Keshar Ghimire; Alexander Plum (NZ Work Research Institute, Faculty of Business, Economics and Law at AUT University)
    Abstract: Between 1997 and 2000, all states in the United States (US) enacted the State Children’s Health Insurance Program (SCHIP) to provide publicly funded health insurance coverage for children in low income families. However, only 15 states including the District of Columbia chose to provide coverage for children of newly arrived immigrants in their SCHIP. We exploite the resulting state and time variation in the implementation of the program in a difference-in-differences framework to estimate the effect of a publicly funded children’s health insurance benefit on immigrant women’s fertility. While estimates from full samples show that the net effect of the program was indistinguishable from zero, we find a significant positive effect on the fertility of unmarried immigrant women, both at extensive and at intensive margin. Our findings have important policy implications for societies experiencing a persistent decline in fertility.
    Keywords: State Children’s Health Insurance Program; Immigrant Fertility; Birth rate; Quantity-quality tradeoff
    JEL: I13 J13
    Date: 2020–08
  6. By: Doidge, Mary
    Keywords: Risk and Uncertainty, Agricultural and Food Policy, Agribusiness
    Date: 2020–07
  7. By: Fontenay, Sébastien (Free University of Brussels); Tojerow, Ilan (Free University of Brussels)
    Abstract: We study how childbirth increases the likelihood of young, working mothers to claim disability insurance and how paternity leave could ease this effect. Our event study analysis uses Belgian data to show that the incidence rate of disability across gender only diverges after first-time childbirth. This "other child penalty" can be reduced with the provision of paternity leave. Our regression discontinuity difference-in-differences design shows that mothers with partners eligible for a two-week-long paternity leave spent on average 21% fewer days on disability over twelve years. Moreover, we show links between this incidence of paternity leave and consequent birth-spacing decisions.
    Keywords: disability insurance, gender, child penalty, paternity leave, maternal health, birth spacing, natural experiment, regression discontinuity, event study
    JEL: J16 J13 I13 H55
    Date: 2020–09
  8. By: Cuong Nguyen; Ilan Noy; Dag Einar Sommervoll; Fang Yao
    Abstract: On the 22nd of February 2011, much of the residential housing stock in the city of Christchurch, New Zealand, was damaged by an unusually destructive earthquake. Almost all of the houses were insured. We ask whether insurance was able to mitigate the damage adequately, or whether the damage from the earthquake, and the associated insurance payments, led to a spatial re-ordering of the housing market in the city. We find a negative correlation between insurance pay-outs and house prices at the local level. We also uncover evidence that suggests that the mechanism behind this result is that in some cases houses were not fixed (i.e., owners having pocketed the payments) - indeed, insurance claims that were actively repaired (rather than paid directly) did not lead to any relative deterioration in prices. We use a genetic machine-learning algorithm which aims to improve on a standard hedonic model, and identify the dynamics of the housing market in the city, and three data sets: All housing market transactions, all earthquake insurance claims submitted to the public insurer, and all of the local authority’s building-consents data. Our results are important not only because the utility of catastrophe insurance is often questioned, but also because understanding what happens to property markets after disasters should be part of the overall assessment of the impact of the disaster itself. Without a quantification of these impacts, it is difficult to design policies that will optimally try to prevent or ameliorate disaster impacts.
    Keywords: house price prediction, machine learning, genetic algorithm, spatial aggregation
    JEL: G22 Q54 R11 R31
    Date: 2020
  9. By: Ana Luiza Neves de Holanda Barbosa (IPC-IG); Miguel Nathan Foguel (IPC-IG); Charlotte Bilo (IPC-IG)
    Abstract: "The main objectives of passive employment policies are to guarantee a certain level of consumption and well-being and to improve the match between employers and workers. In most countries, the unemployment protection system comprises one or more of the following programmes: (i) unemployment insurance: a general fund which makes a certain number of payments calculated on the basis of the (average) previous salary; ii) severance pay: paid by the company after the dismissal of the employee, usually calculated based on the previous salary and the duration of employment in the company; and iii) unemployment individual savings accounts (UISAs): individual mandatory savings accumulated over the period of employment in the company and accessed by the employee after dismissal". (...)
    Keywords: Comparative, analysis, effects, unemployment, insurance, savings, accounts, labour, market
    Date: 2020–04
  10. By: Jonathan Brown; Carol Urato; Precious Ogbuefi
    Abstract: This study used Medicare data to examine the use of new behavioral health integration codes introduced by the Centers for Medicare & Medicaid Services in 2017.
    Keywords: integration, Medicare, behavioral health, primary care, collaborative care, mental health, substance use, coordination
  11. By: Alexis Louaas (CREST - Centre de Recherche en Économie et Statistique - ENSAI - Ecole Nationale de la Statistique et de l'Analyse de l'Information [Bruz] - CNRS - Centre National de la Recherche Scientifique - X - École polytechnique - ENSAE ParisTech - École Nationale de la Statistique et de l'Administration Économique, X-DEP-ECO - Département d'Économie de l'École Polytechnique - X - École polytechnique); Pierre Picard (CREST - Centre de Recherche en Économie et Statistique - ENSAI - Ecole Nationale de la Statistique et de l'Analyse de l'Information [Bruz] - CNRS - Centre National de la Recherche Scientifique - X - École polytechnique - ENSAE ParisTech - École Nationale de la Statistique et de l'Administration Économique, X-DEP-ECO - Département d'Économie de l'École Polytechnique - X - École polytechnique)
    Abstract: We analyze how pandemic business interruption coverage can be put in place by building on capitalization mechanisms. The pandemic risk cannot be mutualized since it affects simultaneously a large number of businesses, and furthermore, it has a systemic nature because it goes along with a severe decline in the real economy. However, as shown by COVID-19, pandemics affect economic sectors in a differentiated way: some of them are very severely affected because their activity is strongly impacted by travel bans and constraints on work organisation, while others are more resistant. This opens the door to risk coverage mechanisms based on a portfolio of financial securities, including long-short positions and options in stock markets. We show that such financial investment allow insurers to offer business interruption coverage in pandemic states, while simultaneously hedging the risks associated with the alternation of bullish and bearish non-pandemic states. These conclusions are derived from a theoretical model of corporate risk management, and they are illustrated by numerical simulations, using data from the French stock exchange.
    Keywords: pandemic,business interruption,insurance,risk management
    Date: 2020–09–17
  12. By: Sarah Bensalem (SAF - Laboratoire de Sciences Actuarielle et Financière - UCBL - Université Claude Bernard Lyon 1 - Université de Lyon)
    Abstract: This article considers an optimization problem for an insurance buyer in the context of proportional insurance and furnishing effort to reduce the size of a potential loss. The buyer's risk preference is given by a distortion risk measure, with risk probabilities being evaluated via a non-concave distortion function. This kind of distortion function reflects potential cognitive biases in the way in which individuals perceive risk probabilities. The buyer will select the optimal level of both insurance coverage and the prevention effort that he/she will furnish to reduce the amount that he/she stands to lose. The distribution of losses is given by a family of stochastically-ordered probability measures, indexed by the prevention effort. Contrary to what is found in the standard economic literature, introducing a non-concave distortion function leads to indeterminacy in the relationship between market insurance and self-insurance. Self-insurance and market insurance may be either substitutes, with a rise in one producing a fall in the other, or complements, so that the two rise or fall together, depending on the price elasticity.
    Keywords: Prevention,Self-insurance,Distortion risk measures,Distortion function,Non-concave distortion,Cognitive bias
    Date: 2020–09–04
  13. By: Atalay, Kadir (University of Sydney); Edwards, Rebecca (University of Sydney); Schurer, Stefanie (University of Sydney); Ubilava, David (University of Sydney)
    Abstract: Worldwide, countries have been restricting work and social activities to counter an emerging public health crisis due to the coronavirus pandemic. These measures have caused dramatic increases in unemployment in the short run, with an expected deepening of the recession in the long run. Some commentators argue that the "draconian measures" will do more harm than good due to the economic contraction, despite a large literature that finds mortality rates decline during recessions. We estimate the relationship between unemployment, a widely accepted proxy for economic climate, and mortality in Australia, a country with universal health care. Using administrative time-series data on mortality that varies by state, age, sex, and cause of death collected for the years 1979-2017, we find no relationship between unemployment and mortality on average. However, we observe beneficial health effects in economic downturns for young men aged 25 to 34 associated with a reduction in vehicle transport accidents. Our estimates imply 425 fewer deaths if Reserve Bank of Australia expectations of a doubling of unemployment rates are realized by the end of 2020. For the early 1980s, we also find a procyclical pattern in the mortality rates of infants. However, this pattern disappears starting from the mid-1980s, coincident with the full implementation of universal health care in Australia in 1984. Our results suggest that universal health care may insulate individuals from the health effects of macroeconomic fluctuations. We conclude that the economic recession is an unlikely mediator for pandemic-related deaths in Australia.
    Keywords: mortality, health, recessions, unemployment, macroeconomic conditions, Australia, COVID-19, pandemic, universal health care
    JEL: I12 E32 E24
    Date: 2020–09
  14. By: Boyd Gilman; Danielle Whicher; Randall Brown; Nancy McCall; Stacy Dale; Laurie Felland; Robert Schmitz; John Schurrer; Lauren Vollmer Forrow; Mark Flick; Jim Derzon; Rizwaan Lakhani
    Abstract: The findings in this report focus on (1) evidence of program impacts on health care service use and costs, (2) factors associated with evidence of favorable impacts, and (3) awardees’ experiences sustaining programs and implementing payment models after the end of the awards.
    Keywords: Health Care Innovation Awards, Round 2, HCIA
  15. By: Lara Hulsey; Andrew Gothro; Joshua Leftin; Liana Washburn; Brian Estes; Kathy Wroblewska; Hilary Wagner; Amanda Lee; Claire Smither Wulsin; Kelsey Chesnut
    Abstract: This summary examines the impact of using Medicaid data to directly certify students for free and reduced-price school meals in the National School Lunch and School Breakfast Programs in fifteen states in School Year 2017-18.
    Keywords: NSLP, SBP, direct certification, Medicaid, school meals
  16. By: Beatriz Burattini (IPC-IG)
    Abstract: COVID-19 is posing an unprecedented challenge to countries' social protection systems. Informal workers are particularly at risk, as they often represent the 'missing middle', covered by neither social assistance nor social insurance. In a recent policy brief, the IPC-IG and UNICEF ROSA analyse the economic fallout from the crisis and the policy measures taken in eight South Asian countries, and advocate for the inclusion of the missing middle in mainstream social protection. This One Pager summarises the study's findings for Afghanistan.
    Keywords: social protection; COVID-19; emergency response; informal workers; Afghanistan
    Date: 2020–09

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