State Health Insurance Market Reform: Toward Inclusive and Sustainable Health Insurance Markets

State Health Insurance Market Reform: Toward Inclusive and Sustainable Health Insurance Markets

State Health Insurance Market Reform: Toward Inclusive and Sustainable Health Insurance Markets

State Health Insurance Market Reform: Toward Inclusive and Sustainable Health Insurance Markets

Synopsis

In this volume, leading American health economists provide a critical assessment of the current state of knowledge of insurance market reform that is accessible to both policy-makers and researchers.

Excerpt

Although the increasing size of the uninsured population in the United States remains an ongoing public concern, there is currently little prospect of system-wide health care reform to address the failure of private health insurance markets to respond to this important policy issue. However, for nearly two decades, state governments have implemented reform of their small-group and individual health insurance markets with the intent of ensuring access to affordable and stable health care coverage. Such reform has been accompanied by keen interest from researchers and policymakers alike as to whether this type of intervention can address the selection and pricing practices of private insurers that have been perceived as limiting the availability of coverage, especially to individuals with health problems. Policymaker interest has stimulated a variety of research on the primary impact of reform on health insurance coverage rates, for both the general population as well as those groups specifically targeted by reform, and on secondary effects of reform regarding labor market outcomes and the structure of private insurance markets. To date, however, there has been little effort to provide a critical assessment of these research findings, their applied methodologies, and the implications of such research for public policy.

The confluence of the broad interest of policymakers and researchers across the country in scrutinizing the impact of insurance regulatory reforms and the specific motivation of decision makers in New Jersey to critically revisit their own pathbreaking regulatory strategy provided the motivation for assembling the chapters in this volume. New Jersey was among the first states to implement comprehensive access and rating regulations in its individual and small-group health insurance markets. After more than a decade of experience with reform, New Jersey policymakers are revisiting that state's regulatory regime. New Jersey's regulators and insurance carriers have been particularly receptive to scrutiny of that state's efforts to encourage affordable access to individual health insurance. Shortly after implementing its major reforms in 1993, and again in 2002, state officials and participating insurance carriers made themselves and their data available to academic researchers. As well, stimulated by

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