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The Future of Healthcare Reform In the United States$
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Anup Malani and Michael H. Schill

Print publication date: 2015

Print ISBN-13: 9780226254951

Published to Chicago Scholarship Online: May 2016

DOI: 10.7208/chicago/9780226255002.001.0001

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PRINTED FROM CHICAGO SCHOLARSHIP ONLINE (www.chicago.universitypressscholarship.com). (c) Copyright University of Chicago Press, 2022. All Rights Reserved. An individual user may print out a PDF of a single chapter of a monograph in CHSO for personal use.date: 26 June 2022

A Cautionary Warning on Healthcare Exchanges

A Cautionary Warning on Healthcare Exchanges

A Plea for Deregulation

(p.329) Chapter Fourteen A Cautionary Warning on Healthcare Exchanges
The Future of Healthcare Reform In the United States

Richard A. Epstein

University of Chicago Press

This chapter reviews regulation in the health care market under the Affordable Care Act (ACA). It begins with a description of the difficulties inherent in health care insurance markets. A review of the work of Rebitzer, Taylor, and Votruba follows, which is criticized on the whole for overstating the gains from regulation. Specifically, the chapter questions Rebitzer's claims of informational advantages that the insurer has over the insured, that a high turnover rate is evidence of latent market imperfection, that a public agency has the expertise to operate successfully in this market niche, and that the proliferation of consumer health care options poses an impediment to successful market operation. The chapter suggests that restrictions on entry, mandates for minimum essential benefits, privacy regulations, and the inability of private institutions to contract out of the standard-issue terms for medical practice be removed. The chapter then cites the ways in which the ACA deviates from standard insurance principles and concludes that the government's new marketplace metaphor downplays both the massive regulations and the subsidies built in to the ACA exchanges, which negate the benefits that ordinarily derive from organizing voluntary exchanges.

Keywords:   insurance exchange, insurance markets, Affordable Care Act, ACA, deregulation, health care reform

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