How has small group market reform affected employee health insurance coverage?

• 成果类型: Article
• 署名作者: Monheit, AC; Schone, BS
• 署名单位: Agency for Healthcare Research & Quality; Rutgers University System; Rutgers University New Brunswick; Rutgers University Biomedical & Health Sciences
• 刊物名称: JOURNAL OF PUBLIC ECONOMICS
• ISSN/ISSBN: 0047-2727
• DOI: 10.1016/S0047-2727(02)00133-0
• 发表日期: 2004
• 页码: 237-254
• 关键词: Health insurance; small group market reform

摘要

In the early 1990s, over 40 states passed legislation designed to limit a number of exclusionary practices by insurers in the small group market in order to improve the availability and affordability of health insurance to employees in small firms. In this paper, we address the effects of reform on the likelihood that workers are offered insurance, have employment-based coverage, or are policyholders of an employment-based plan. We use differences-in-differences (DD) and differences-indifferences-in-differences (DDD) estimators to evaluate the differential effects of alternative reform measures on high and low risk workers. We generally find little effect of refonn on offer rates and find that, in states with the most stringent reform, employment-based coverage and policyholder rates increased for high risk workers relative to low risk workers. Our results also indicate that the effects of reform varied significantly by the extent to which states adopted guaranteed issue. (C) 2002 Elsevier B.V. All rights reserved.