Private Health Insurance and Risk Protection: Changes in Out-of-Pocket Medical Spending, 2001 and 2011

  • Minkyoung Yoo
Original Article


Changes in the cost-sharing provisions of employment-sponsored health insurance in the 2000s were designed to control U.S. health-care spending. However, such provisions may also increase the financial burden on families who need medical care and may differentially affect families according to their socioeconomic characteristics and the health status of family members. Additionally, changes in cost sharing may alter the entire shape of the out-of-pocket spending distribution. Using quantile regressions, I assess whether the distribution of out-of-pocket spending and hence the risk-protection function of private insurance has been affected by such changes. The empirical results reveal that families who are likely to incur higher health-care spending because of family members’ existing health conditions were most affected by changes in cost sharing, while families with older policyholders at higher percentiles of the out-of-pocket spending distribution experienced decreases in such spending.


private health insurance risk protection out-of-pocket medical spending quantile regression 



I am deeply indebted to Alan Monheit for his guidance and persistent encouragement. I also thank Louise Russell, Hilary Sigman, and two anonymous referees for helpful discussions and comments. All errors are mine.


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Copyright information

© The International Association for the Study of Insurance Economics 2014

Authors and Affiliations

  • Minkyoung Yoo
    • 1
  1. 1.Department of PharmacotherapyUniversity of UtahSalt Lake CityU.S.A.

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