Do Health Plans Risk-Select? An Audit Study on Germany’s Social Health Insurance

Citation:

Bauhoff, Sebastian. 2012. Do Health Plans Risk-Select? An Audit Study on Germany’s Social Health Insurance. Journal of Public Economics 96, no. 9-10: 750–759. Copy at http://j.mp/MNeI6O

Abstract:

This paper evaluates whether health plans in Germany's Social Health Insurance select on an easily observable predictor of risk: geography. To identify plan behavior separately from concurrent demand-side adverse selection, I implement a double-blind audit study in which plans are contacted by fictitious applicants from different locations. I find that plans are less likely to respond and follow-up with applicants from higher-cost regions, such as West Germany. The results suggest that supply-side selection may emerge even in heavily regulated insurance markets. The prospect of risk selection by firms has implications for studies of demand-side selection and regulatory policy in these settings.

Published paper (gated)

Prepublication draft488.72 KB