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Health-insurance premiums account for a significant portion of the cost base of U.S. corporations. A recent study finds that health-insurance premiums increase for firms that experience positive profit shocks, suggesting that the health-insurance market is not perfectly competitive (Dafny 2010). Motivated by this finding and the economic importance of health-insurance premiums, this is the first study to examine firms’ earnings-management incentives in the face of insurance carriers with strong bargaining power. Using an innovative dataset for a large sample of U.S. firms with detailed information on insurance premiums and insurance-plan characteristics, we find that firms manage their reported earnings downward when insurance providers have strong bargaining power. This finding holds using both association tests and a natural experiment. We further show that this effect is more pronounced in settings in which there are ex-ante reasons to expect stronger incentives to manage earnings. We also provide preliminary evidence suggesting that downward earnings management has the intended effect of reducing future health-insurance premiums. Our analyses highlight an inefficient health-insurance market as an important determinant of firms’ accounting choices.
Ole-Kristian Hope, University of Toronto
Francesco Bova, University of Toronto
Yiwei Dou, New York University