Gerardo Ruiz Sanchez

Bio: Gerardo Ruiz Sanchez is an academic researcher from Trinity College (Connecticut). The author has contributed to research in topics: Demography & 2019-20 coronavirus outbreak. The author has an hindex of 1, co-authored 2 publications receiving 3 citations. Previous affiliations of Gerardo Ruiz Sanchez include Trinity College, Dublin.

Demand for Health Insurance in the Time of COVID-19: Evidence from the Special Enrollment Period in the Washington State ACA Marketplace

Abstract: I study the demand for health insurance during the COVID-19 pandemic using Special Enrollment Period (SEP) individual-level enrollment data from the Washington State Affordable Care Act Marketplace. I document that most individuals enrolling in plans during the pandemic are those who lost minimum essential coverage, followed by uninsured individuals making use of Washington’s limited-time SEP for uninsured individuals. I estimate a demand model and find that low-income individuals and young individuals are more premium sensitive. I find that 20.4 percent of the individuals in my analysis sample did not pay their initial premium. Individuals losing minimum essential coverage are less likely to pay their initial premium than individuals using the SEP for other qualifying events. Lower income individuals are less likely to pay the initial premium than higher income individuals. My results suggest three reasons for considering more generous premium subsidies during the remainder of the pandemic: (1) individuals losing minimum essential coverage are already using the exchange to replace lost coverage, (2) consumers are premium sensitive, and (3) there are meaningful differences across demographic groups in the probability of paying the first premium, which is necessary for coverage to take effect.

Health insurance market structure and state-based public option laws: evidence from Washington State

Abstract: In response to political gridlock at the federal level and concerns about market concentration in the private health insurance industry, several U.S. states have proposed their own bills to establish state-based public option programs, including three that recently became law in Washington State, Colorado, and Nevada. I study Washington State’s Cascade Care Law, which implemented a state-based public option program in its individual health insurance market starting in 2021. I use plan offering data and administrative enrollment data from the Washington Health Benefit Exchange, Washington’s state-based Affordable Care Act exchange, to provide a descriptive analysis of how market structure, insurers’ plan offering decisions, individual enrollment, and market concentration evolved during the 2020–2022 plan years. A key descriptive finding of this paper is that county-level insurance market competition has improved since Washington’s state-based public option program was implemented; with thirteen and twelve insurers offering plans in 2021 and 2022, respectively, up from nine insurers in 2020. I also document considerable variation in the set of plans insurers decided to offer and the set of counties they served. Enrollment in the public option plans that were offered was low.

The U.S. Labor Market During the Beginning of the Pandemic Recession

Abstract: Using weekly, anonymized administrative payroll data from the largest U.S. payroll processing company, we measure the deterioration of the U.S. labor market during the first two months of the global COVID-19 pandemic. We find that U.S. private-sector employment contracted by about 22 percent between mid-February and mid-April. Businesses suspending operations—perhaps temporarily—account for a significant share of employment losses, particularly among smaller businesses. Hours worked for continuing workers fell by 4.5 percent. We highlight large differences in employment declines by industry, business size, state of residence, and demographic group. Workers in the bottom quintile of the wage distribution experienced a 35 percent employment decline while those in the top quintile experienced only a 9 percent decline. Large differences across the wage distribution persist even after conditioning on worker age, business industry, business size, and worker location. As a result, average base wages increased by over 5 percent, though this increase arose entirely through a composition effect. Over- all, we document that the speed and magnitude of labor market deterioration during the early parts of the pandemic were unprecedented in the postwar period, particularly for the bottom of the earnings distribution.

Demand for Health Insurance Marketplace Plans Was Highly Elastic in 2014-2015

Abstract: A major provision of the Affordable Care Act was the creation of Health Insurance Marketplaces, which began operating for the 2014 plan year. Although enrollment initially grew in these markets, enrollment has fallen recently amid insurer exits and rising premiums. To better understand these markets, we estimate premium elasticity of demand for Marketplace plans, using within-plan premium changes from 2014 to 2015, accounting for state-specific trends and simultaneous changes in generosity. Our preferred estimate implies that a one percent premium increase reduces plan-specific enrollment by 1.7 percent. We argue that this high elasticity reflects the rapid growth and high churn in this market, as well as the high degree of standardization and the availability of many close substitutes.

The Affordable Care Act and the COVID-19 pandemic: A regression discontinuity analysis

Abstract: Did Medicaid expansion under the Affordable Care Act affect the course of the COVID-19 pandemic? We answer this question using a regression discontinuity design for counties near the borders of states that expanded Medicaid with states that did not. Relevant covariates change continuously across the Medicaid expansion frontier. We find that 1) health insurance changes discontinuously at the frontier, 2) COVID-19 cases do not change discontinuously at the frontier but the precision of this estimate is low, 3) COVID-19 deaths do not change discontinuously at the frontier and the confidence intervals exclude large declines in deaths in Medicaid expansion areas, 4) smart thermometer readings of fever rates from Kinsa, Inc. do not change discontinuously at the frontier, and 5) COVID-19-related doctor visits discontinuously increase in Medicaid expansion areas.

Etické a zákonné požadavky na podstoupení očkování k prevenci nemoci COVID-19

Abstract: V současné době existuje eminentní zájem států na proočkovanosti obyvatelstva proti COVID-19. V České republice k tomuto účelu slouží podmínečně registrované genové mRNA a vektorové DNA vakcíny, u kterých zatím absentují úplné a dlouhodobé údaje o bezpečn