Monday, October 5th, 2015 12:47 pm

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
 

Source: IGM Economic Experts Panel
www.igmchicago.org/igm-economic-experts-panel

Responses weighted by each expert's confidence

Source: IGM Economic Experts Panel
www.igmchicago.org/igm-economic-experts-panel

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
 

Source: IGM Economic Experts Panel
www.igmchicago.org/igm-economic-experts-panel

Responses weighted by each expert's confidence

Source: IGM Economic Experts Panel
www.igmchicago.org/igm-economic-experts-panel

Question A Participant Responses

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

Question B Participant Responses

Participant University Vote Confidence Comment Bio/Vote History
Acemoglu Daron Acemoglu MIT Agree 3
A lot of uncertainty, and ACA has a lot of problems (esp. to rein in costs and tackle distortions). Probably still benefits outweigh costs.
Bio/Vote History
         
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
That's just a prior. No evidence yet
Bio/Vote History
         
Baicker Katherine Baicker Harvard 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
Likely yes, though there are substantial uncertainties.
Bio/Vote History
         
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
The resulting gains include better health for newly covered, and fewer preventable high-cost diseases to treat. The total should be enough.
Bio/Vote History
         
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 Chicago Agree 3
i think yes but ultimately involves thorny issues of valuing improvements in health and reductions in consumption risk
Bio/Vote History
         
Hall Robert Hall Stanford Disagree 3
The expansion of coverage was mainly intended to bring in healthy people whose payments would exceed their medical costs.
Bio/Vote History
         
Hart Oliver Hart Harvard Strongly Agree 10
ACA allows ill people to see doctors and provides peace of mind. Both would be negotiated behind the veil of ignorance. Net benefit>0.
Bio/Vote History
         
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 Disagree 3
The experiments in Oregon suggest the benefits are modest and the costs higher. But, there is stiil much uncertainty.
Bio/Vote History
         
Kashyap Anil Kashyap Chicago 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
Basic medical care, especially preventative care, brings gains that are large compared to the costs.
Bio/Vote History
         
Scheinkman José Scheinkman Princeton Agree 4
Bio/Vote History
         
Schmalensee Richard Schmalensee MIT Agree 4
This is, of course, the rationale for the program, and it is not implausible.
Bio/Vote History
         
Shapiro Carl Shapiro Berkeley Strongly Agree 8
Bio/Vote History
         
Shimer Robert Shimer Chicago Did Not Answer
Bio/Vote History
         
Thaler Richard Thaler Chicago Agree 5
Bio/Vote History
         
Udry Christopher Udry Yale Agree 4
Very difficult question. Counting cost properly is hard enough; valuing the benefits even more challenging.
Bio/Vote History
         

10 New Economic Experts join the IGM Panel


For the past two years, our expert panelists have been informing the public about the extent to which economists agree or disagree on important public policy issues. This week, we are delighted to announce that we are expanding the IGM Economic Experts Panel to add ten new distinguished economists. Like our other experts, these new panelists have impeccable qualifications to speak on public policy matters, and their names will be familiar to other economists and the media.

To give the public a broad sense of their views on policy issues, each new expert has responded to a selection of 16 statements that our panel had previously addressed. We chose these 16 statements, which cover a wide range of important policy areas, because the original panelists' responses to them were analyzed in a paper comparing the views of our economic experts with those of the American public. You can find that paper, by Paola Sapienza and Luigi Zingales, here. The paper, along with other analyses of the experts' views, was discussed during the American Economic Association annual meetings, and the video can be found here.

The new panelists' responses to these statements can be seen on their individual voting history pages. Our ten new economic experts are:

Abhijit Banerjee (MIT)
Markus K. Brunnermeier (Princeton)
Liran Einav (Stanford)
Amy Finkelstein (MIT)
Oliver Hart (Harvard)
Hilary Hoynes (Berkeley)
Steven N. Kaplan (Chicago)
Larry Samuelson (Yale)
Carl Shapiro (Berkeley)
Robert Shimer (Chicago)


Please note that, for the 16 previous topics on which these new panelists have voted, we left the charts showing the distribution of responses unchanged. Those charts reflect the responses that our original panelists gave at the time, and we have not altered them to reflect the views of the new experts.

We have also taken this opportunity to ask our original panelists whether they would vote differently on any of the statements we have asked about in the past. Several experts chose to highlight statements to which they would currently respond differently. In such cases, you will see this "revote" below the panelist's original vote. We think you will enjoy seeing examples of statements on which some experts have reconsidered.

As with the 16 previous statements voted on by new panelists, these "revote" responses are not reflected in the chart that we display showing the distribution of views for that topic: all the charts for previous questions reflect the distribution of views that the experts expressed when the statement was originally posed.

About the IGM Economic Experts Panel

This panel explores the extent to which economists agree or disagree on major public policy issues. To assess such beliefs we assembled this panel of expert economists. Statistics teaches that a sample of (say) 40 opinions will be adequate to reflect a broader population if the sample is representative of that population.

To that end, our panel was chosen to include distinguished experts with a keen interest in public policy from the major areas of economics, to be geographically diverse, and to include Democrats, Republicans and Independents as well as older and younger scholars. The panel members are all senior faculty at the most elite research universities in the United States. The panel includes Nobel Laureates, John Bates Clark Medalists, fellows of the Econometric society, past Presidents of both the American Economics Association and American Finance Association, past Democratic and Republican members of the President's Council of Economics, and past and current editors of the leading journals in the profession. This selection process has the advantage of not only providing a set of panelists whose names will be familiar to other economists and the media, but also delivers a group with impeccable qualifications to speak on public policy matters.

Finally, it is important to explain one aspect of our voting process. In some instances a panelist may neither agree nor disagree with a statement, and there can be two very different reasons for this. One case occurs when an economist is an expert on a topic and yet sees the evidence on the exact claim at hand as ambiguous. In such cases our panelists vote "uncertain". A second case relates to statements on topics so far removed from the economist's expertise that he or she feels unqualified to vote. In this case, our panelists vote "no opinion".

The Economic Experts Panel questions are emailed individually to the members of the panel, and each responds electronically at his or her convenience. Panelists may consult whatever resources they like before answering.

Members of the public are free to suggest questions (see link below), and the panelists suggest many themselves. Members of the IGM faculty are responsible for deciding the final version of each week’s question. We usually send a draft of the question to the panel in advance, and invite them to point out problems with the wording if they see any. In response, we typically receive a handful of suggested clarifications from individual experts. This process helps us to spot inconsistencies, and to reduce vagueness or problems of interpretation.

The panel data are copyrighted by the Initiative on Global Markets and are being analyzed for an article to appear in a leading peer-reviewed journal.

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