title: Who gains and who loses with community rating for small business?
abstract: This paper compares community rating with experience rating for small businesses using a microsimulation model to determine what firms offer and who within these firms purchases insurance. We generate four years of data and find that our results are remarkably stable through time. Both offer and purchase rates are about five percentage points higher under experience rating, but community rating leads to more stable offerings. Under community rating, high-risk firms and families purchase insurance, whereas under experience rating, it is the low-risk firms and families who are the purchasers. Young families and poor families have the lowest purchase rates, with these rates being disproportionately low under community rating.
authors.affiliation: Department of Health Care Policy, Harvard Medical School, Boston, MA 02115, USA.
authors.forename: J L
authors.initials: JL
authors.lastname: Buchanan
authors.forename: M S
authors.initials: MS
authors.lastname: Marquis
mesh_terms: D000367:Age Factors; D003258:Consumer Behavior / Q000191:economics; D017047:Cost Sharing / Q000191:economics; D003657:Decision Making; D005190:Family / Q000523:psychology*; D006264:Health Benefit Plans, Employee / Q000191:economics* / Q000706:statistics & numerical data*; D006801:Humans; D007182:Income / Q000706:statistics & numerical data; D019458:Insurance Coverage / Q000191:economics; D015271:Insurance Pools / Q000191:economics*; D017059:Models, Econometric; D008960:Models, Psychological; D011203:Poverty / Q000191:economics; D011907:Rate Setting and Review / Q000379:methods*; D015203:Reproducibility of Results; D020414:Risk Sharing, Financial; D013997:Time Factors; D014481:United States