【保险学术前沿】期刊JPE 2025年（上）保险精选文章目录与摘要

声明：本系列文章基于原期刊目录和摘要内容整理而得，仅限于读者交流学习。如有侵权，请联系删除。

期刊介绍：

《Journal of Public Economics》（公共经济学杂志）是一本专注于公共经济学领域的学术期刊。该期刊自1972年成立以来，涉及的主题包括税收政策、公共支出、社会保障、公共选择理论、环境经济学、劳动经济学、教育经济学、卫生经济学、城市经济学和发展经济学等。它探讨了公共政策的效率和分配问题，以及需求者、供应者和其他卫生保健机构的行为模型。该刊每年发行12期，平均每期发表10篇左右，2024年影响因子为3.5。

本期看点：

失业保险：

●在美国，白人和黑人在领取失业保险福利方面存在显著不平等：失业后黑人领取失业保险的可能性比白人低 30%，领取的福利金额也比白人少 46%。

●失业保险福利的撤回会导致就业率上升，且这种上升在那些财务受限、可用信用额度有限的个体中最为显著，但也伴随着对其他政府服务需求的上升和更高的违约率。

残疾保险：

●残疾保险政策将“现金断崖”机制（即收入超过某一门槛后福利立即归零）替换为“福利递减坡道”机制（即福利随着收入逐步减少），对受益人的收入、总收入以及福利金额均无显著影响。

医疗保险：

●将医疗补助（Medicaid）服务外包给私人健康保险公司后所产生的动态财政成本，在过渡在初期财政成本略微降低，但随后几年中 Medicaid 的支出持续上升。

●医疗补助（Medicaid）管理式医疗（MMC）强制政策实施后在医疗质量方面产生了积极影响，还通过增加接受Medicaid患者的医生数量，扩大了受益人的就医可及性，非Medicaid的私人投保人群的常规门诊也有所增加。

●医疗改革：对一组特定疾病的诊疗程序和及时保障的标准化医疗改革，该改革所涵盖疾病的死亡率平均下降了 4.4%，实现了多发伤住院患者医疗服务使用率的均等化。

遗产动机：

●已婚夫妇中一方去世后所产生的遗产分配情况与单身人士所留下的遗产非常相似，没有发现支持“利他主义”或“家族传承”模型的证据。不同类型的资产在遗产分配上呈现出不同的模式。尽管不动产通常平均分配，父母却常常将人寿保险，尤其是住房资产，不平均地分配，倾向于留给照料过他们的子女。选择性剥夺某些子女（尤其是继子女）继承权的现象也较为普遍。

※ 本期目录

●Racial inequality in unemployment insurance receipt

●Between a rock and a hard place: The costs and benefits of expanded unemployment insurance benefits

●Can changes in disability insurance work incentives influence beneficiary employment? Evidence from the promoting opportunity demonstration

●The dynamic fiscal costs of outsourcinghealth insurance - evidence from Medicaid

●What do bequests in married couples with a surviving spouse tell us about bequest motives?

●The impact of standardized disease-specific healthcare coverage

●How does medicaid managed care affect provider behavior? New evidence from spillovers on private health care

Racial inequality in unemployment insurance receipt

失业保险领取中的种族不平等

作者

Elira Kuka（乔治华盛顿大学；美国国家经济研究局（NBER）），Bryan A. Stuart（费城联邦储备银行）

摘要：This paper studies differences in unemployment insurance (UI) benefit receipt among White and Black individuals. We combine data containing detailed information on individuals’ work history and UI receipt with state-level UI regulations. Black individuals who separate from a job are 30 % less likely to receive UI and receive 46 % fewer benefits than White individuals. These gaps are similar in magnitude among individuals who are likely eligible for UI. Statistical decompositions indicate that 37 % of the gap in UI receipt and 65 % of the gap in UI benefit amount are explained by Black workers’ lower pre-unemployment earnings and higher tendency to live in the South.

本文研究了白人和黑人在领取失业保险（UI）福利方面的差异。我们结合了包含个体工作经历和失业保险领取情况的详细数据，以及州一级的失业保险政策。研究发现，失业后黑人领取失业保险的可能性比白人低 30%，领取的福利金额也比白人少 46%。在可能符合领取条件的群体中，这些差距的幅度相似。统计分解结果表明，黑人工人较低的失业前收入水平和更高的南部居住比例可解释 UI 领取概率差距的 37%，以及领取金额差距的 65%。

Between a rock and a hard place: The costs and benefits of expanded unemployment insurance benefits

进退维谷：扩展失业保险福利的成本与收益

作者

Naser Hamdi（Equifax公司），Ankit Kalda（印第安纳大学凯利商学院），David Sovich（肯塔基大学加顿商学院）

摘要：We examine how the withdrawal of the largest expansion of unemployment insurance (UI) benefits in United States history affected job-finding, demand for other government assistance, and credit defaults. Using administrative UI data merged with credit records and applications for Medicaid and SNAP, we show that UI withdrawal led to an increase in job-finding that was most pronounced among financially constrained individuals with limited available credit. The cost savings from higher job-finding came at the expense of increased demand for other government services and higher defaults. Our results highlight an important interaction between UI, household finances, and other social insurance programs.

我们研究了美国历史上最大规模失业保险（UI）福利扩张取消后，对就业、其他政府援助需求以及信用违约的影响。通过将行政 UI 数据与信用记录以及医疗补助（Medicaid）和补充营养援助计划（SNAP）的申请数据相结合，我们发现 UI 福利的撤回导致就业率上升，且这种上升在那些财务受限、可用信用额度有限的个体中最为显著。尽管更高的就业率带来了财政节约，但也伴随着对其他政府服务需求的上升和更高的违约率。我们的研究结果强调了 UI、家庭财务状况与其他社会保障项目之间的重要联动关系。

Can changes in disability insurance work incentives influence beneficiary employment? Evidence from the promoting opportunity demonstration

改变残疾保险的工作激励是否会影响受益人就业？来自“促进机会示范项目”的证据

作者

Michael Levere（科尔盖特大学），David Wittenburg（Westat 研究机构），John T. Jones（美国社会保障署（Social Security Administration））

摘要：We study how disability beneficiary work behavior responds to a rule change that replaces a cash cliff—a threshold above which benefits reduce to zero—with a benefit offset ramp—where benefits are gradually phased out. Using a randomized controlled trial with over 10,000 Social Security Disability Insurance beneficiaries who voluntarily enrolled in the demonstration, we find precisely estimated null effects on earnings, income, and benefit amounts. An analysis of mechanisms indicates that administrative burden, the limited size of the incentive, and individual and systemic barriers to employment for people with disabilities likely contributed to the limited impacts.

我们研究了残疾保险受益人在面对规则变化时的工作行为反应。该规则将原先的“现金断崖”机制（即收入超过某一门槛后福利立即归零）替换为“福利递减坡道”机制（即福利随着收入逐步减少）。基于一项覆盖逾 10,000 名自愿参与的社会保障残疾保险受益人的随机对照试验（RCT），我们发现该政策对受益人的收入、总收入以及福利金额均无显著影响。机制分析显示，行政负担、激励幅度有限，以及残疾人面临的个体和制度性就业障碍，可能是导致政策影响有限的主要原因。

The dynamic fiscal costs of outsourcing health insurance - evidence from Medicaid

外包健康保险的动态财政成本 —— 来自医疗补助（Medicaid）的证据

作者

Timothy J. Layton（弗吉尼亚大学巴顿领导与公共政策学院；美国国家经济研究局（NBER）），

Eran Politzer（耶路撒冷希伯来大学费德曼公共政策与治理学院）

摘要：We study the dynamics of fiscal costs following the outsourcing of Medicaid provision to private health insurers by states. We focus on beneficiaries with disabilities who account for a third of Medicaid’s spending. Using a national administrative database, we identify county-level private plan enrollment mandates and exploit them as an instrument for individuals’ transition to managed care plans. These transitions, while initially slightly reducing fiscal costs, lead to a continuous increase in Medicaid’s costs over subsequent years. Counties subject to mandates experience a 9.8 % higher cost 4 years post-mandate compared to those without mandates. “Actuarially sound" endogenous payment rates, that are based on past costs in the market, may serve as a mechanism underlying the rising spending.

我们研究了各州将医疗补助（Medicaid）服务外包给私人健康保险公司后所产生的动态财政成本。研究重点聚焦于占 Medicaid 支出三分之一的残疾人受益群体。利用国家级的行政数据库，我们识别出县级层面的私人计划强制参保政策，并将其作为个体过渡到管理式医疗计划（managed care plans）的工具变量。研究发现，这些过渡在初期略微降低了财政成本，但随后几年中 Medicaid 的支出持续上升。在实施强制政策的县，四年后其成本比未实施县高出 9.8%。基于该地区历史支出而制定的“精算合理”（actuarially sound）内生支付费率，可能是导致支出持续增长的机制之一。

What do bequests in married couples with a surviving spouse tell us about bequest motives?

已婚夫妇中一方去世后的遗产分配能揭示什么样的遗产动机？

作者

Sean Fahle（霍恩海姆大学）

摘要：This paper studies the bequests that arise in married couples after the death of the first spouse. It provides the first systematic examination of these bequests using representative data from the United States on the actual (not intended or expected) bequests made to each of the couple’s children. I find that these bequests are divided among children very similarly to the bequests left by single individuals, which have been the near-exclusive focus of the literature. In both cases, I observe strong support for theories of bequests based on exchange and evolutionary psychology and no evidence for altruistic or dynastic models. Also novel to this paper, I document that different types of assets—residences, estates, and life insurance—exhibit different bequest patterns. While estates are typically equally divided, parents often divide life insurance and especially housing assets unequally, often leaving these assets to caregiving children. Selective disinheritance of certain children, particularly stepchildren, is common.

本文研究了已婚夫妇中一方去世后所产生的遗产分配情况，并首次系统地使用来自美国的代表性数据，对夫妇各自的子女实际获得的遗产（而非意图或预期中的遗产）进行分析。研究发现，这些遗产在子女之间的分配方式与单身人士所留下的遗产非常相似，而后者一直是现有文献关注的主要对象。在这两类情况下，研究均发现支持基于交换理论和进化心理学的遗产动机理论，而没有发现支持“利他主义”或“家族传承”模型的证据。此外，本文还首次揭示，不同类型的资产——住宅、不动产和人寿保险——在遗产分配上呈现出不同的模式。尽管不动产通常平均分配，父母却常常将人寿保险，尤其是住房资产，不平均地分配，倾向于留给照料过他们的子女。选择性剥夺某些子女（尤其是继子女）继承权的现象也较为普遍。

The impact of standardized disease-specific healthcare coverage

标准化特定疾病医疗保障的影响

作者

Felipe Menares（美洲开发银行），Pablo Muñoz（智利大学经济与商业学院经济学系）

摘要：We study the impact of a healthcare reform that standardized procedures and timely coverage of a set of diseases. Using Chile’s universe of death records and a difference-in-differences research design, we show that mortality from the diseases covered by this reform decreased by 4.4% on average. Disease-specific shocks or a resource shift from non-covered to covered diseases do not explain this effect. Evidence from polytraumatized inpatients suggests that the reform equalized utilization rates as it reduced the dispersion of risk-adjusted surgery rates and spending across hospitals.

我们研究了一项医疗改革的影响，该改革对一组特定疾病的诊疗程序和及时保障进行了标准化。利用智利全国的死亡记录数据，并采用双重差分（difference-in-differences）研究设计，我们发现该改革所涵盖疾病的死亡率平均下降了 4.4%。这一效果并不能用疾病特有冲击或医疗资源从未涵盖疾病向涵盖疾病的转移来解释。对多发伤住院患者的证据表明，该改革实现了医疗服务使用率的均等化——通过减少医院间风险调整后的手术率和医疗支出的差异，降低了资源使用的离散程度。

How does Medicaid managed care affect provider behavior? New evidence from spillovers on private health care

医疗补助管理式医疗如何影响医疗服务提供者行为？来自私人医疗的外溢效应新证据

作者

Ajin Lee（加利福尼亚大学经济系）

摘要：Medicaid is increasingly provided by private managed care plans. I examine the direct effect of Medicaid privatization on health care utilization of Medicaid beneficiaries as well as the indirect effect on non-Medicaid privately insured individuals. Exploiting the staggered rollout of the Medicaid managed care (MMC) mandate across counties in New York, I find evidence of quality improvements under MMC, such as increased routine office visits and child immunizations. MMC also expanded Medicaid beneficiaries’ access to physicians by increasing the number of providers treating Medicaid patients. I find that routine office visits similarly increased for non-Medicaid privately insured individuals, and the same-signed spillover effect is larger in low-income areas. My findings suggest that physicians may have updated their overall practice styles when the mandate affected a large share of their patients.

越来越多的医疗补助（Medicaid）服务通过私人管理式医疗计划（managed care plans）提供。本文研究了医疗补助私有化对其受益人医疗服务使用的直接影响，以及对非医疗补助、私人投保人群的间接影响。利用纽约州各县分阶段推行Medicaid管理式医疗（MMC）强制政策的差异，本文发现 MMC 实施后在医疗质量方面产生了积极影响，例如常规门诊次数和儿童疫苗接种率上升。MMC 还通过增加接受Medicaid患者的医生数量，扩大了受益人的就医可及性。此外，本文还发现，非Medicaid的私人投保人群的常规门诊也有所增加，这一“同方向”的外溢效应在低收入地区更为显著。研究结果表明，当强制政策影响到医生大量患者时，医生可能会整体调整其执业风格。

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