Health Insurance Design Meets Saving Incentives: Consumer Responses to Complex Contracts
利用大雇主行政数据和断点回归设计，估计健康储蓄账户（HSA）的边际消费倾向为0.85，拒绝新古典基准0，发现HSA未降低医疗支出，反而增加了免税融资比例。
To lower health care costs, Health Savings Accounts (HSAs) offer tax incentives encouraging people to trade off current consumption against future consumption. This paper tests whether consumers use HSAs as self-insurance over the life cycle. Using administrative data from a large employer and a regression discontinuity design, I estimate the marginal propensity to consume from HSA assets is 0.85 and reject the neoclassical benchmark of 0. Comparisons with 401(k) saving show most employees do not treat HSA money as fungible with retirement savings. In this setting, HSAs did not reduce health spending and instead increased the share that was financed tax-free.