US

Health Insurance Subsidies

Question A:

Expanding health insurance to more people through the ACA’s public subsidies and Medicaid expansion will reduce total healthcare spending in the economy.

Responses weighted by each expert's confidence

Question B:

Expanding health insurance to more people through the ACA’s public subsidies and Medicaid expansion will generate gains in the health and well-being of the newly insured that exceed the costs.

Responses weighted by each expert's confidence

Question A Participant Responses

Participant University Vote Confidence Bio/Vote History
Acemoglu
Daron Acemoglu
MIT
Uncertain
3
Bio/Vote History
Alesina
Alberto Alesina
Harvard
Uncertain
2
Bio/Vote History
Altonji
Joseph Altonji
Yale
Disagree
6
Bio/Vote History
Auerbach
Alan Auerbach
Berkeley
Strongly Disagree
7
Bio/Vote History
Autor
David Autor
MIT
Strongly Disagree
6
Bio/Vote History
First result from Oregon study: People with health insurance use more healthcare
Baicker
Katherine Baicker
University of Chicago
Strongly Disagree
6
Bio/Vote History
Banerjee
Abhijit Banerjee
MIT
Disagree
5
Bio/Vote History
Bertrand
Marianne Bertrand
Chicago
Uncertain
3
Bio/Vote History
Brunnermeier
Markus Brunnermeier
Princeton
Uncertain
5
Bio/Vote History
Chetty
Raj Chetty
Harvard
Disagree
7
Bio/Vote History
Chevalier
Judith Chevalier
Yale
Uncertain
5
Bio/Vote History
It is unlikely to reduce healthcare spending, but I am not aware of a full assessment.
-see background information here
Cutler
David Cutler
Harvard
Uncertain
6
Bio/Vote History
The timing is really important here. Long term can be very different from short term; costs more likely to fall in the long term.
Deaton
Angus Deaton
Princeton
Disagree
7
Bio/Vote History
Duffie
Darrell Duffie
Stanford
Disagree
6
Bio/Vote History
It's hard to believe that spending per person receiving services will go down enough to offset the number of people getting health care.
Edlin
Aaron Edlin
Berkeley
Disagree
6
Bio/Vote History
More insurance could lead to more usage and more spending. The countervailing hope is cost containment or prevention of expensive treatment.
Eichengreen
Barry Eichengreen
Berkeley
Uncertain
1
Bio/Vote History
Many countervailing factors, though I am weakly inclined toward the agree side of uncertain.
Einav
Liran Einav
Stanford
Disagree
8
Bio/Vote History
Fair
Ray Fair
Yale
Uncertain
5
Bio/Vote History
Finkelstein
Amy Finkelstein
MIT
Strongly Disagree
10
Bio/Vote History
Basic economic theory (demand curves slope down) + tons empirical evidence - RAND HIE + Oregon HIE + many quasi-experimental studies
Goldberg
Pinelopi Goldberg
Yale
Uncertain
5
Bio/Vote History
Goolsbee
Austan Goolsbee
Chicago
Uncertain
5
Bio/Vote History
Greenstone
Michael Greenstone
University of Chicago
Disagree
4
Bio/Vote History
Hall
Robert Hall
Stanford
Disagree
3
Bio/Vote History
The ACA caved to demands for excessively broad coverage.
Hart
Oliver Hart
Harvard
Uncertain
5
Bio/Vote History
It could fall as people get more preventative care; or rise as people use doctors more. Some evidence suggests the latter but it's early.
Holmström
Bengt Holmström
MIT
Agree
5
Bio/Vote History
Hoxby
Caroline Hoxby
Stanford
Strongly Disagree
9
Bio/Vote History
Hoynes
Hilary Hoynes
Berkeley
Uncertain
9
Bio/Vote History
Judd
Kenneth Judd
Stanford
Uncertain
5
Bio/Vote History
Kaplan
Steven Kaplan
Chicago Booth
Strongly Disagree
10
Bio/Vote History
When you increase availability, you get more demand. In our institutional environment, very hard to see how costs do not go up.
Kashyap
Anil Kashyap
Chicago Booth
Disagree
7
Bio/Vote History
Klenow
Pete Klenow
Stanford
Disagree
3
Bio/Vote History
Levin
Jonathan Levin
Stanford Did Not Answer Bio/Vote History
Maskin
Eric Maskin
Harvard
Disagree
6
Bio/Vote History
Certain kinds of acute-care spending may fall due to better preventative care. But an overall fall in spending seems unlikely
Nordhaus
William Nordhaus
Yale
Disagree
4
Bio/Vote History
Saez
Emmanuel Saez
Berkeley
Disagree
6
Bio/Vote History
Samuelson
Larry Samuelson
Yale
Agree
8
Bio/Vote History
Health care insurance should provide care more efficiently than the current lack of insurance coupled with reliance on emergency services.
Scheinkman
José Scheinkman
Columbia University
No Opinion
Bio/Vote History
Schmalensee
Richard Schmalensee
MIT
Disagree
3
Bio/Vote History
A big switch from reliance on emergency rooms to prevention could do this, but this does not seem likely.
Shapiro
Carl Shapiro
Berkeley
Uncertain
6
Bio/Vote History
Shimer
Robert Shimer
University of Chicago Did Not Answer Bio/Vote History
Thaler
Richard Thaler
Chicago Booth
Agree
1
Bio/Vote History
Obviously could go either way.
Udry
Christopher Udry
Northwestern
Disagree
6
Bio/Vote History
Demand curves usually slope down. Evidence is that this is true for health care. Cost savings measures will mitigate but not outweigh this.

Question B Participant Responses

Participant University Vote Confidence Bio/Vote History
Acemoglu
Daron Acemoglu
MIT
Agree
3
Bio/Vote History
A lot of uncertainty, and ACA has a lot of problems (esp. to rein in costs and tackle distortions). Probably still benefits outweigh costs.
Alesina
Alberto Alesina
Harvard
Uncertain
1
Bio/Vote History
Altonji
Joseph Altonji
Yale
Agree
6
Bio/Vote History
Auerbach
Alan Auerbach
Berkeley
Agree
3
Bio/Vote History
Autor
David Autor
MIT
Agree
5
Bio/Vote History
That's just a prior. No evidence yet
Baicker
Katherine Baicker
University of Chicago
Uncertain
5
Bio/Vote History
Banerjee
Abhijit Banerjee
MIT
Strongly Agree
7
Bio/Vote History
Bertrand
Marianne Bertrand
Chicago
Uncertain
3
Bio/Vote History
Brunnermeier
Markus Brunnermeier
Princeton
Agree
9
Bio/Vote History
Chetty
Raj Chetty
Harvard
Uncertain
7
Bio/Vote History
Chevalier
Judith Chevalier
Yale
Agree
6
Bio/Vote History
Likely yes, though there are substantial uncertainties.
Cutler
David Cutler
Harvard
Strongly Agree
6
Bio/Vote History
Deaton
Angus Deaton
Princeton
Strongly Agree
7
Bio/Vote History
Duffie
Darrell Duffie
Stanford
Agree
6
Bio/Vote History
The resulting gains include better health for newly covered, and fewer preventable high-cost diseases to treat. The total should be enough.
Edlin
Aaron Edlin
Berkeley
Agree
7
Bio/Vote History
Eichengreen
Barry Eichengreen
Berkeley
Agree
5
Bio/Vote History
Einav
Liran Einav
Stanford
Agree
7
Bio/Vote History
Fair
Ray Fair
Yale
Uncertain
5
Bio/Vote History
Finkelstein
Amy Finkelstein
MIT
Uncertain
7
Bio/Vote History
Goldberg
Pinelopi Goldberg
Yale
Agree
5
Bio/Vote History
Goolsbee
Austan Goolsbee
Chicago
Agree
9
Bio/Vote History
Greenstone
Michael Greenstone
University of Chicago
Agree
3
Bio/Vote History
i think yes but ultimately involves thorny issues of valuing improvements in health and reductions in consumption risk
Hall
Robert Hall
Stanford
Disagree
3
Bio/Vote History
The expansion of coverage was mainly intended to bring in healthy people whose payments would exceed their medical costs.
Hart
Oliver Hart
Harvard
Strongly Agree
10
Bio/Vote History
ACA allows ill people to see doctors and provides peace of mind. Both would be negotiated behind the veil of ignorance. Net benefit>0.
Holmström
Bengt Holmström
MIT
Agree
7
Bio/Vote History
Hoxby
Caroline Hoxby
Stanford
Uncertain
10
Bio/Vote History
Hoynes
Hilary Hoynes
Berkeley
Agree
9
Bio/Vote History
Judd
Kenneth Judd
Stanford
Agree
7
Bio/Vote History
Kaplan
Steven Kaplan
Chicago Booth
Disagree
3
Bio/Vote History
The experiments in Oregon suggest the benefits are modest and the costs higher. But, there is stiil much uncertainty.
Kashyap
Anil Kashyap
Chicago Booth
Uncertain
3
Bio/Vote History
Klenow
Pete Klenow
Stanford
Uncertain
3
Bio/Vote History
Levin
Jonathan Levin
Stanford Did Not Answer Bio/Vote History
Maskin
Eric Maskin
Harvard
Agree
7
Bio/Vote History
Nordhaus
William Nordhaus
Yale
Agree
6
Bio/Vote History
Saez
Emmanuel Saez
Berkeley
Strongly Agree
8
Bio/Vote History
Samuelson
Larry Samuelson
Yale
Agree
8
Bio/Vote History
Basic medical care, especially preventative care, brings gains that are large compared to the costs.
Scheinkman
José Scheinkman
Columbia University
Agree
4
Bio/Vote History
Schmalensee
Richard Schmalensee
MIT
Agree
4
Bio/Vote History
This is, of course, the rationale for the program, and it is not implausible.
Shapiro
Carl Shapiro
Berkeley
Strongly Agree
8
Bio/Vote History
Shimer
Robert Shimer
University of Chicago Did Not Answer Bio/Vote History
Thaler
Richard Thaler
Chicago Booth
Agree
5
Bio/Vote History
Udry
Christopher Udry
Northwestern
Agree
4
Bio/Vote History
Very difficult question. Counting cost properly is hard enough; valuing the benefits even more challenging.