Performance Improvement 2009. How Does People's Health Insurance Status Change Over Time; What Types of Coverage Do They Have?


This study analyzed data from a major national survey to better understand who had health insurance coverage in recent years, and how their coverage changed. The study examined the impact of risk on ‘point-in-time’ coverage and changes in coverage.

Although the individual market was less stable than the group market, retention rates appeared high for the self-employed — those best-suited for the individual market. High-risk people appeared to be significantly more likely to be covered than healthy people in the group market relative to the individual market. High-risk people initially-uninsured were more likely to obtain coverage in the individual market and the large-group market, and high-risk people who were initially-insured in the large-group market seemed to be significantly more likely to lose their coverage. High-risk individuals tended to obtain more generous coverage than their healthy counterparts. The larger the firm one was employed with, the more generous coverage one obtained. No evidence was found that being high-risk was associated with a higher premium or that the onset of a chronic condition was associated with an increase in the premium from one year to the next. Guaranteed renewability was successful in providing protection against ‘reclassification risk’ in individual insurance markets but low sample size prohibits a conclusive inference.

Report Title: Changes in Coverage in the Individual and Group Health Insurance Markets and the Effect of Health Status
Agency Sponsor: ASPE-ODALTCP, Office of Disability, Aging, and Long-Term Care Policy
Federal Contact: John Drabek, 202-690-6443
Performer: Johns Hopkins University
PIC ID: 8907

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"PerformanceImprovement2009.pdf" (pdf, 1.26Mb)

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