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Funding employer-based insurance: regressive taxation and premium exclusions

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Abstract

In the US, health insurance is linked to employment. The tax code treats health insurance premiums preferentially for employers, but not individuals. We show that this regressive policy reduces talent mis-allocation in two ways: (i) The larger tax benefit to those with higher health risk and managerial talent, conditional on being entrepreneurs, alters the incentive to be an entrepreneur. (ii) This enlarges the tax base, which reduces the effective tax rate, and increases wage and capital income. Our general equilibrium model with heterogeneous agents shows that the subsidy can increase welfare, with a maximum gain of 0.46% in consumption equivalent variation.

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References

  • Antonio, A., Cavalcanti, T., Villamil, A.: The effect of financial repression and enforcement on entrepreneurship and economic development. J. Monet. Econ. 55(2), 278–297 (2008)

  • Antonio, A., Cavalcanti, T., Villamil, A.: The effects of credit subsides on development. Econ. Theor 58, 1–30 (2015)

  • Aizawa, N., Fang, H.: Equilibrium labor market search and health insurance reform. J. Polit. Econ. 128(11), 4258–4336 (2020)

  • Autor, D., Dorn, D., Katz, L.F., Patterson, C., Van Reenen, J.: Concentrating on the fall of the labor share. Am. Econ. Rev. 107(5), 180–185 (2017)

    Article  Google Scholar 

  • Buchmueller, T.C., Monheit, A.C.: Employer-sponsored health insurance and the promise of health insurance reform. Inquiry 46(2), 187–202 (2009)

    Article  Google Scholar 

  • Cardon, M.S., Patel, P.C.: Entrepreneurial stress. Appl. Psychol. 64, 379–420 (2015)

    Article  Google Scholar 

  • CBO: Budget and Economic Outlook. https://www.cbo.gov/publication/51129 (2016)

  • CBO: Reduce taxsubsidies for employment-based health Insurance. https://www.cbo.gov/budget-options/54798 (2018)

  • Chen, C., Feng, Z., Gu, J.: Health, health insurance and inequality. mimeo (2020)

  • Chivers, D., Feng, Z., Villamil, A.: Employment-based health insurance and misallocation: implications for the macroeconomy. Rev. Econ. Dyn. 23(1), 125–149 (2017)

    Article  Google Scholar 

  • Cole, H.L., Kim, S., Krueger, D.: Analyzing the effects of insuring health risks: on the trade-off between short run insurance benefits vs long run incentive costs. Rev. Econ. Stud. 86(3), 1123–1169 (2019)

    Article  Google Scholar 

  • Conesa, J.C., Kitao, S., Krueger, D.: Taxing capital? Not a bad idea after all!. Am. Econ. Rev. 99(1), 25–48932 (2009)

    Article  Google Scholar 

  • DeCicca, P.: Health insurance availability and entrepreneurship. Upjohn Institute Working Paper (2012)

  • da Costa, C.E., Maestri, L.: Optimal Mirrleesian taxation in non-competitive labor markets. J. Econ Theory 68, 845–886 (2019)

    Article  Google Scholar 

  • Fairlie, R.W., Kapur, K., Gates, S.: Is employer-based health insurance a barrier to entrepreneurship? J. Health Econ. 30(1), 146–162 (2011)

    Article  Google Scholar 

  • Feldstein, M.: The effects of taxation on risk taking. J. Polit. Econ. 77(5), 755–764 (1969)

    Article  Google Scholar 

  • Feng, Z.: Macroeconomic Analysis of Universal Coverage in the U.S., in Chai, S. K., Salemo, J. J., Mabry, P. L. Social Computing, Behavioral Modeling and Prediction 2010 (pp. 87-96). New York: Springer (2010)

  • Feng, Z., Zhao, K.: Employment-based health insurance, uncertain medical expenses, and aggregate labor supply. J. Econ. Behav. Organ. 154, 156–174 (2017)

    Article  Google Scholar 

  • Gai, Y: Minniti, M, : Health insurance, job lock, and the supply of self-employment. J. Small Bus. Manag. 53(2), 558–580 (2015)

  • Goenka, A., Liu, L.: Infectious diseases, human capital and economic growth. Econ. Theory 70, 1–47 (2020)

    Article  Google Scholar 

  • Gruber, J.: The tax exclusion for employer-sponsored health insurance. Nat. Tax J. 64, 511–530 (2011)

    Article  Google Scholar 

  • Guner, N., Ventura, G., Yi, X.: Macroeconomic implications of size-dependent policies. Rev. Econ. Dyn. 11(4), 721–744 (2008)

    Article  Google Scholar 

  • Hai, R.: The determinants of rising inequality of health insurance and wages (2017)

  • Heathcote, J., Storesletten, K., Violante, G.: Consumption and labor supply with partial insurance: an analytical framework. Am. Econ. Rev. 104(7), 2075–2126 (2014)

  • Heathcote, J., Storesletten, K., Violante, G.: Optimal tax progressivity: an analytical framework. Quart. J. Econ. 132(4), 1693–1754 (2017)

    Article  Google Scholar 

  • Heim, B., Lurie, I.: The effect of self-employed health insurance subsidies on self-employment. J. Public Econ. 94(11–12), 995–1007 (2010)

    Article  Google Scholar 

  • Hubbard, R.G., Skinner, J., Zeldes, S.P.: Precautionary saving and social insurance. J. Polit. Econ. 103(2), 360–399 (1995)

    Article  Google Scholar 

  • Jackson, E., Looney, A., Ramnath, S.: The rise of alternative work arrangements: evidence and implications for tax filing and benefit coverage. ILR Rev. 72(2), 382–416 (2019)

    Article  Google Scholar 

  • Jeske, K., Kitao, S.: US tax policy and health insurance demand: can a regressive policy improve welfare? J. Monet. Econ. 56(2), 210–221 (2009)

    Article  Google Scholar 

  • Kaiser Family Foundation: Employer Health Benefits. http://files.kff.org/attachment/Report-Employer-Health-Benefits-2016-Annual-Survey (2016)

  • Kitao, S.: Entrepreneurship, taxation and capital investment. Rev. Econ. Dyn. 11(1), 44–69 (2008)

    Article  Google Scholar 

  • Lucas Jr., Robert, E.: On the Size Distribution of Business Firms. Bell Journal of Economics 9(2), 508–523 (1978)

  • Nakajima, M., Tuzemen, D.: Health-care reform or labor market reform? A quantitative analysis of the affordable care act (2016)

  • Pashchenko, S., Porapakkarm, P.: Quantitative analysis of health insurance reform: separating regulation from redistribution. Rev. Econ. Dyn. 16(3), 383–404 (2013)

    Article  Google Scholar 

  • Restuccia, D., Rogerson, R.: Misallocation and productivity. Rev. Econ. Dyn. 16(1), 1–10 (2013)

    Article  Google Scholar 

  • Scheuer, F.: Adverse selection in credit markets and regressive profit taxation. J. Econ. Theory 148, 1333–1360 (2013)

    Article  Google Scholar 

  • Scheuer, F.: Entrepreneurial taxation with endogenous entry. Am. Econ. J. Econ. Policy 6, 126–163 (2014)

    Article  Google Scholar 

  • Storesletten, K., Telmer, C.I., Yaron, A.: Cyclical dynamics in idiosyncratic labor-market risk. J. Polit. Econ. 112(3), 695–717 (2004)

    Article  Google Scholar 

  • Tauchen, G., Hussey, R.: Quadrature-based methods for obtaining approximate solutions to nonlinear asset pricing models. Econometrica 59(2), 317–396 (1991)

    Article  Google Scholar 

  • Wan, J., Zhu, S.: Bequests, estate taxes, and wealth distributions. Econ Theory 67, 179–210 (2019)

    Article  Google Scholar 

  • Wellington, A.: Health insurance coverage and entrepreneurship. Contemp. Econom. Policy 19(4), 465–478 (2001)

    Article  Google Scholar 

Download references

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Authors and Affiliations

  1. Department of Economics, University of Nebraska-Omaha, Omaha, NE, 68106, USA

    Zhigang Feng

  2. School of Economics, Zhongnan University of Economics and Law, Wuhan, China

    Zhigang Feng

  3. Department of Economics, University of Iowa, Iowa City, IA, 52242, USA

    Anne Villamil

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  1. Zhigang Feng
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  2. Anne Villamil
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Correspondence to Anne Villamil.

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We thank Tiago Cavalcanti, David Chivers, David Enocksson, Soojin Kim, Matthew C. Weinzierl and Constantine Yannelis for helpful discussions, and seminar participants at 2017 Econometric Society Summer Meeting, Midwest Macro Meeting at Purdue, Mini-Conference on Quantitative Macro and Public Finance at University of Illinois, Federal Reserve Bank at Atlanta, Ohio University, SAET-Faro, SED Edinburgh Meeting, SHUFE, SWET Paris1, University of Iowa, University of Miami, University of Zurich, University of Oslo, SUNY Stony Brook, University of Nebraska-Omaha, University of Wisconsin at Whitewater, Wuhan University, Xiamen Univesity, and Zhongnan University of Economics and Law. We would also like to thank the Editor and the two anonymous referees for their thoughtful comments.

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Feng, Z., Villamil, A. Funding employer-based insurance: regressive taxation and premium exclusions. Econ Theory 73, 509–540 (2022). https://doi.org/10.1007/s00199-021-01368-3

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