Adverse selection is a potentially significant problem in the individual (n
ongroup) health insurance markets if states use regulations to restrict ins
urance companies' ability to select whom they will insure. In 1993, New Jer
sey implemented the Individual Health Coverage Program (IHCP), presenting a
n opportunity to test for adverse selection when insurers' ability to selec
t enrollees is severely restricted. The authors collected socioeconomic, de
mographic, and health status data from a sample of 2,211 adults covered by
IHCP policies and compared the IHCP enrollee characteristics with those of
two control groups of New Jersey residents (uninsured adults and adults wit
h employer group insurance). Adverse selection does not appear to have occu
rred against the IHCP. However, the IHCP premiums were not cheap, and the f
indings suggest that people who can afford to purchase individual insurance
and do so are, on average, healthier than those who do not choose to enrol
l, probably because the latter cannot afford insurance.