The nongroup market as one element of a broader coverage-expansion strategy.
Effective health insurance provides financial protection and access to services that maintain and improve health. Such coverage is difficult to obtain in the nongroup market, however, because of a lack of sponsorship, the nature of coverage available, adverse selection, and high administrative costs. However, certain interventions could make this market an effective avenue for expanding coverage to moderate- to high-income persons who lack access to employer-based coverage. In "less regulated" markets, we suggest broader, deeper funding of high-risk pools and standardization of benefits, preexisting condition exclusions, and waiting periods. In "more regulated" markets, a broadly funded reinsurance mechanism could moderate premiums.
Tollen
Laura
L
Kaiser Permanente Institute for Health Policy, Kaiser Foundation Health Plan, Inc., Oakland, California, USA.
Crane
Robert M
RM
Liu
Ruth
R
Zatkin
Steve
S
D005249:Fees and Charges; D006801:Humans; D019458:Insurance Coverage / Q000191:economics / Q000458:organization & administration*; D015271:Insurance Pools / Q000331:legislation & jurisprudence; D015273:Insurance Selection Bias; D007348:Insurance, Health / Q000145:classification / Q000191:economics* / Q000331:legislation & jurisprudence; D017057:Medically Uninsured; D011050:Policy Making; D012923:Social Class; D014481:United States