Employee Choice and the Demand for Health Insurance Coverage: Evidence from Random Coefficients Models

Abstract

Abstract This study examines the effects of deductibles, employee premium contributions, and the availability of tax-sheltered health savings accounts on employee selection into health insurance plans after passage of the Affordable Care Act, and particularly after implementation of the individual mandate. In doing so, a utility-based structural demand model is applied to market-level macro data from the Kaiser Family Foundation and the Health Research Educational Trust. Results from random coefficients models indicate that for an average consumer, price sensitivity for employer-sponsored health insurance plans varies by age, wage, health condition and gender. Employees who are older, obese, or female are less sensitive to deductibles and premiums than younger and healthier employees, or male employees. These findings suggest that high deductible health plans that combine a tax-sheltered account with higher deductibles will negatively impact the utility of older employees and females as compared to younger employees and males.