Premium variation in the individual health insurance market.
Recent proposals to decrease the number of uninsured in the U.S. indicate that the individual health insurance market's role may increase. Amid fears of possible risk-segmentation in individual insurance, there exists limited information of the functioning of such markets. This paper examines the relationship between expected medical expense and actual paid premiums for households with individual insurance in the 1996-1997 Community Tracking Study's Household Survey. We find that premiums vary less than proportionately with expected expense and vary only with certain risk characteristics. We also explore how the relationship between risk and premiums is affected by local regulations and market characteristics. We find that premiums vary significantly less strongly with risk for persons insured by HMOs and in markets dominated by managed care insurers.
Herring
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B
Institute for Social and Policy Studies, Yale University, 89 Trumbull Street, New Haven, CT 06520, USA. bradley.herring@yale.edu
Pauly
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MV
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005191:Family Characteristics; D005249:Fees and Charges / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015273:Insurance Selection Bias; D007348:Insurance, Health / Q000191:economics* / Q000331:legislation & jurisprudence; D008297:Male; D017057:Medically Uninsured; D008875:Middle Aged; D020379:Risk Adjustment; D014481:United States