Buntin MB, Marquis S; AcademyHealth. Meeting (2005 : Boston, Mass.).
Abstr AcademyHealth Meet. 2005; 22: abstract no. 3481.
RAND, Health, 1200 South Hayes St., Arlington, VA 22202 Tel. 703 413 1100 Fax
RESEARCH OBJECTIVE: To examine how much pooling of risks occurs among potential purchasers in the individual market, how much pooling occurs among those who purchase coverage, and whether there is greater pooling among longer-term enrollees. STUDY DESIGN: Logit models were fit to estimate the difference in 5 health outcome measures between the insured and uninsured after adjusting for other factors that affect insurance status and health. Multinominal models were also fit to explore the relationship between health and three measures of pooling in the market: plan type, pricing tier, and the actuarially adjusted premium paid by the enrollee. POPULATION STUDIED: Enrollees in individual insurance plans in California in 2001, and surveyed samples of individually insured and uninsured Californians. PRINCIPAL FINDINGS: Those who purchase individual health insurance are in better health than those who remain uninsured. On the other hand, a large share of people with health problems do obtain individual insurance. The distribution of subscribers across plan type and pricing tier varies with their health status. Those in poor health are less likely to purchase low benefit plans. There is less separation of risks for those who become sick after enrollment based on the measure of pricing tier. The distribution of subscribers across plan type for those who have health problems at enrollment and those who become sick differs, but so does the distribution of those who become sick and those who remain healthy. CONCLUSIONS: Despite small differences among the healthy and sick, our results support the conclusion that there is considerable risk pooling in the individual market. To some extent, this pooling occurs because underwriting happens at the time people enroll and there is greater pooling among those who become sick than those who enroll sick. IMPLICATIONS FOR POLICY, DELIVERY OR PRACTICE: Results point to the importance of guaranteed renewal, required by the Health Insurance Portability and Accountability Act (HIPAA), for risk pooling in the individual market. Our results also suggest, however, that Health Savings Accounts may further fragment the market.
Publication Types:
Keywords:
- California
- Health Insurance Portability and Accountability Act
- Health Status
- Insurance Coverage
- Insurance, Health
- Medically Uninsured
- economics
- hsrmtgs
UI: 103622944
From Meeting Abstracts