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Polarisation and Public Policy: Political Adverse Selection under Obamacare

delete2026-02-01
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PRE
AI
L
Leonardo Bursztyn *
J
Jonathan Kolstad
A
Aakaash Rao
P
Pietro Tebaldi
N
Noam Yuchtman
DOI:10.1093/ej/ueaf079delete
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Abstract

Abstract

En 中文
Politicising policies designed to address market failures can diminish their effectiveness. We document a pattern of 'political adverse selection' in the health insurance exchanges established under the Affordable Care Act (colloquially, 'Obamacare'): Republicans enrolled at lower rates than Democrats and independents, a gap driven by healthier Republicans. This selection raised public subsidy spending by approximately $155 per enrollee annually (3.2% of average cost). We fielded a survey to show that this selection does not exist for other insurance products. Lower enrolment and higher costs are concentrated in more Republican areas, potentially contributing to polarised views of the policy.
Keywords:
HEALTH-INSURANCE
CONSEQUENCES
PARTISANSHIP
COMPETITION
PRIVATE

Journal

Economic Journal cover
Economic Journal
IF:
3.6
Papers:
5.5K
Citations:
1.6W

Organization

No organization information available
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