Genetic adverse selection: Evidence from long-term care insurance and Huntington disease

Emily Oster, Ira Shoulson, Kimberly Quaid, E. Ray Dorsey

Research output: Contribution to journalArticle

24 Scopus citations


Individual, personalized genetic information is increasingly available, leading to the possibility of greater adverse selection over time, particularly in individual-payer insurance markets. We use data on individuals at risk for Huntington disease (HD), a degenerative neurological disorder with significant effects on morbidity, to estimate adverse selection in long-term care insurance. We find strong evidence of adverse selection: individuals who carry the HD genetic mutation are up to 5 times as likely as the general population to own long-term care insurance. This finding is supported both by comparing individuals at risk for HD to those in the general population and by comparing across tested individuals in the HD-risk population with and without the HD mutation.

Original languageEnglish (US)
Pages (from-to)1041-1050
Number of pages10
JournalJournal of Public Economics
Issue number11-12
StatePublished - Dec 1 2010


  • Adverse selection
  • Genetic testing
  • Huntington disease
  • Long-term care insurance

ASJC Scopus subject areas

  • Economics and Econometrics
  • Finance

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