Examining Substitution: State Strategies to Limit "Crowd Out" in the Era of Children's Health Insurance Expansions. Mechanism 5: Purchasing Cooperatives


Health insurance purchasing cooperatives, which assist employers in purchasing insurance at more affordable rates, are enabling small employers to offer benefits in Oregon and Rhode Island. The State supported Associated Oregon Industries’ (AOI) efforts to develop a privately sponsored Health Insurance Purchasing Cooperative (HIPC) targeted at small group employers. AOI, Oregon’s largest business organization, shows promise for assisting small employers in maintaining existing or establishing new insurance programs to employees. Rhode Island has four small business purchasing cooperatives that may be deterring crowd out by making the provision of insurance by small businesses affordable.