Association for Public Policy Analysis & Management

This project sets out to evaluate state regulatory policies in the case of health insurance with a focus on the effect of mandated benefit coverage on insurance premiums and employee contributions for single individuals, employees plus 1, and families in employer-provided health plans across all states from 1996 to 2010, the period immediately following the failure of the Clinton health reforms efforts and the passage of the last, albeit relatively minor, federal reforms in the form of the Health Insurance Portability and Accountability Act. Do these insurance mandates raise the cost of insurance or the contributions of employees to their insurance premiums? And, if so, can states mitigate these effect by adding expertise to the legislative process in the form of so-called Benefit Review Programs? Finally, are employees of businesses certain sizes more affected than those of others? The topic has only gained in importance with passage of the Affordable Care Act (ACA) and the expansion of coverage through Medicaid and insurance exchanges because almost all Americans will be required to obtain coverage while at the same time premiums, even with subsidies, might be prohibitively unaffordable. The individual mandate makes a better understanding of the financial effects of mandates on insurance premiums is crucial.