An alternative approach to measuring the effects of insurance market reforms

Reforms in the small group and individual insurance markets could make it e asier for the currently insured to keep their coverage, and could expand co verage by making insurance more accessible to the currently uninsured. We u se data from the 1989 through 1995 Current Population Survey to measure the impact of these reforms on state-level rates of uninsurance and private he alth insurance coverage. Instead of examining the effect of each of the var ious types of insurance market reforms, we estimate the impact of packages of reforms on insurance coverage, reflecting how policies were implemented. We find that small group reforms have done little to affect insurance cove rage. Individual market reforms, on the other hand, appear to increase unin surance rates and reduce private coverage. Our findings suggest that small group reforms may have prevented erosion of private coverage, but have not reduced the numbers of uninsured people.