Pauly, Mark V.; Mitchell, Olivia S.; Zeng, Yuhui - 2004
policy. Our results suggest that implementing a significant risk adjustment had no discernable effect on adverse selection … inefficient for almost all workers even in the absence of adverse selection"--National Bureau of Economic Research web site … but premiums do not fully reflect these risk differences, this can give rise to a so-called "death spiral" due to adverse …