Winners and Losers Under Counterfactual Health Risk Pooling
With Victoria Marone
We study public policy proposals that would decouple health risk pools from employment pools in the US. These policies, such as ‘Medicare for All,’ would pool health risk at the state or national level, overturning the status quo of pooling risks at the firm level. Generally speaking, firms with on average healthy employees would be worse off, and firms with on average sick employees would be better off, but little is known about the extent of existing variation along this dimension. We analyze a large, national data set of individuals with employer-sponsored health insurance and present novel evidence on the variation in average health spending across firms.