In health insurance markets with regulated competition, regulators face the challenge of preventing risk selection. This paper provides a framework for analyzing the scope (i.e., potential actions by insurers and consumers) and incentives for risk selection in such markets. Our approach consists of three steps. First, we describe four types of risk selection: (a) selection by consumers in and out of the market, (b) selection by consumers between high- and low-value plans, (c) selection by insurers via plan design, and (d) selection by insurers via other channels such as marketing, customer service, and supplementary insurance. In a second step, we develop a conceptual framework of how regulation and features of health insurance markets affect the scope and incentives for risk selection along these four dimensions. In a third step, we use this framework to compare nine health insurance markets with regulated competition in Australia, Europe, Israel, and the United States.

中文翻译：

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受监管竞争的健康保险市场风险选择的范围和激励措施：概念框架和国际比较

在竞争受监管的健康保险市场中，监管机构面临着阻止风险选择的挑战。本文提供了一个框架，用于分析此类市场中风险选择的范围（即保险公司和消费者的潜在行动）和激励因素。我们的方法包括三个步骤。首先，我们描述四种类型的风险选择：（a）市场内外消费者的选择，（b）消费者在高价值和低价值计划之间的选择，（c）保险公司通过计划设计进行选择，以及（ d) 保险公司通过营销、客户服务、补充保险等其他渠道进行选择。第二步，我们制定一个概念框架，说明健康保险市场的监管和特征如何影响这四个维度的风险选择的范围和激励。第三步，我们使用这个框架对澳大利亚、欧洲、以色列和美国的九个受监管竞争的健康保险市场进行比较。