Private vs. Public Provision of Social Insurance: Evidence from Medicaid / Timothy J. Layton, Nicole Maestas, Daniel Prinz, Boris Vabson.

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Layton, Timothy J

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Material type: Text

TextSeries: Working Paper Series (National Bureau of Economic Research) ; no. w26042.Publication details: Cambridge, Mass. National Bureau of Economic Research 2019.Description: 1 online resource: illustrations (black and white)Subject(s):

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Abstract: Public health insurance benefits in the U.S. are increasingly provided by private firms, despite mixed evidence on welfare effects. We investigate the impact of privatization in Medicaid by exploiting the staggered introduction of county-level mandates in Texas that required disabled beneficiaries to switch from public to private plans. Compared to the public program, which used blunt rationing to control costs, we find privatization led to improvements in healthcare--including increased consumption of high-value drug treatments and fewer avoidable hospitalizations--but also higher Medicaid spending. We conclude that private provision can be beneficial when constraints in the public setting limit efficiency.

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Item type	Home library	Collection	Call number	Status	Date due	Barcode	Item holds
Working Paper	Biblioteca Digital	Colección NBER	nber w26042 (Browse shelf(Opens below))	Not For Loan

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July 2019.

Public health insurance benefits in the U.S. are increasingly provided by private firms, despite mixed evidence on welfare effects. We investigate the impact of privatization in Medicaid by exploiting the staggered introduction of county-level mandates in Texas that required disabled beneficiaries to switch from public to private plans. Compared to the public program, which used blunt rationing to control costs, we find privatization led to improvements in healthcare--including increased consumption of high-value drug treatments and fewer avoidable hospitalizations--but also higher Medicaid spending. We conclude that private provision can be beneficial when constraints in the public setting limit efficiency.