"Using administrative data from Massachusetts' subsidized insurance exchange, ... [the authors] estimate willingness to pay and costs of insurance among low-income adults. As subsidies decline, insurance take-up falls rapidly, dropping about 25% for each $40 increase in monthly enrollee premiums. Marginal enrollees tend to be lower-cost, consistent with adverse selection into insurance. But across the entire distribution we can observe -- approximately the bottom 70% of the willingness to pay distribution -- enrollee willingness to pay is always less than half of own expected costs."

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