世界银行-社会违约与计划选择：配偶追随案例（英）

Policy Research Working Paper11207Social Defaults and Plan ChoiceThe Case of Spousal FollowingTal Gross Tim Layton Daniel Prinz Julia YatesEconomic Policy Global Department September 2025 Public Disclosure AuthorizedPublic Disclosure AuthorizedPublic Disclosure AuthorizedPublic Disclosure AuthorizedProduced by the Research Support TeamAbstractThe Policy Research Working Paper Series disseminates the findings of work in progress to encourage the exchange of ideas about development issues. An objective of the series is to get the findings out quickly, even if the presentations are less than fully polished. The papers carry the names of the authors and should be cited accordingly. The findings, interpretations, and conclusions expressed in this paper are entirely those of the authors. They do not necessarily represent the views of the International Bank for Reconstruction and Development/World Bank and its affiliated organizations, or those of the Executive Directors of the World Bank or the governments they represent.Policy Research Working Paper 11207This paper studies how couples in the Medicare Part D pro-gram choose an insurance plan. Over 70 percent of enrollees choose the same plan as their spouse. Even among those with differing health care needs, well over half do so. Dis-crete- choice models suggest that beneficiaries place a value of more than $1,000 per year on being on the same plan as their spouse. Using a regression-discontinuity design, the paper shows that younger spouses disproportionately follow their older spouse’s plan choice. Joint plan choice contributes modestly to overall overspending, but increases costs substantially for couples with different cost-minimiz-ing plans.This paper is a product of the Economic Policy Global Department. It is part of a larger effort by the World Bank to provide open access to its research and make a contribution to development policy discussions around the world. Policy Research Working Papers are also posted on the Web at http://www.worldbank.org/prwp. The authors may be contacted at dprinz@worldbank.org. Social Defaults and Plan Choice:The Case of Spousal Following∗Tal Gross†Tim Layton‡Daniel Prinz§Julia Yates¶JEL codes I13, H31Keywords: Health insurance choice, Social defaults, Spousal decision-making∗We are grateful to Keith Ericson, Sandra Gain, Jim Rebitzer, ´Agnes Szab´o-Morvai, Roula Yazigi,and seminar participants at Lehigh University, Purdue University, Stanford University, the Univer-sity of Georgia, Georgia State University, the University of Ottawa, the University of Pennsylvania,the University of Virginia, the University of San Diego, the University of Duisburg-Essen, and theCERS Institute of Economics for useful feedback. Amanda Stiebris provided superb research assis-tance. Research reported in this publication was supported by the National Institute on Aging ofthe National Institutes of Health under Award Number P30AG012810 through the National Bureauof Economic Research Center