Patterns of individual health insurance coverage, 1996-2000

Health Affairs

Volumn 23, Issue 6, 2004, Pages 210-221

  Ziller, Erika C ^a   Coburn, Andrew F ^c   McBride, Timothy D ^b   Andrews, Courtney ^c  

^a UNIVERSITY OF SOUTHERN MAINE   (United States)

^b SAINT LOUIS UNIVERSITY   (United States)

^c NONE

Author keywords

[No Author keywords available]

Indexed keywords

ADULT; CONTROLLED STUDY; HEALTH CARE; HEALTH CARE COST; HEALTH CARE PLANNING; HEALTH CARE POLICY; HEALTH INSURANCE; HUMAN; MEDICAID; MEDICARE; PRIVATE HEALTH INSURANCE; PUBLIC HEALTH INSURANCE; REVIEW; STATISTICAL ANALYSIS;

ADOLESCENT; ADULT; DATA COLLECTION; FEMALE; HEALTH CARE REFORM; HUMANS; INSURANCE COVERAGE; MALE; MIDDLE AGED; UNITED STATES;

EID: 8844246455     PISSN: 02782715     EISSN: None     Source Type: Journal    
DOI: 10.1377/hlthaff.23.6.210     Document Type: Review

References (16)

1. R. Cunningham, "Joint Custody: Bipartisan Interest Expands Scope of Tax-Credit Proposals," Health Affairs, 18 September 2002, content.healthaffairs.org/cgi/content/abstract/hlthaff.w2.290 (2 August 2004).
2. M.V. Pauly and L.M. Nichols, "The Nongroup Health Insurance Market: Short on Facts, Long on Opinions and Policy Disputes," Health Affairs, 23 October 2002, content.healthaffairs.org/cgi/content/abstract/hlthaff .w2.325 (2 August 2004).
3. D.L. Rogal and A.K. Gauthier, "Introduction: The Evolution of the Individual Insurance Market," Journal of Health Politics, Policy and Law 25, no. 1 (2000): 3-8.
4. D.J. Chollet, "Consumers, Insurers, and Market Behavior," Journal of Health Politics, Policy and Law 25, no. 1 (2000): 27-44.
5. I b i d.
6. For complete information on SIPP, see www.census.sipp.gov (14 June 2004).
7. Chollet, "Consumers, Insurers, and Market Behavior"; and U.S. Government Accountability Office, Private Health Insurance: Millions Relying on Individual Market Face Cost and Coverage Trade-offs (Washington: GAO, 26 November 1996).
8. Chollet, "Consumers, Insurers, and Market Behavior"; and U.S. Government Accountability Office, Private Health Insurance: Millions Relying on Individual Market Face Cost and Coverage Trade-offs (Washington: GAO, 26 November 1996).
9. P.D. Allison, Survival Analysis using the SAS System: A Practical Guide (Cary, N.C.: SAS Institute, December 1995).
10. We estimated a parametric survival model using a Weibull distribution and PROC LIFEREG in SAS (see ibid.).
11. Chollet, "Consumers, Insurers, and Market Behavior."
12. For more information on the Assessing the New Federalism (ANF) project and the state database, see Urban Institute, "Assessing the New Federalism," 2001, www.urban.org/Content/Research/NewFederalism/AboutANF/ AboutANF.htm (14 June 2004).
13. This estimate is close to those produced for other studies. For example, Deborah Chollet and Adele Kirk found that 7.7 percent of the nonelderly had individual insurance in 1996, based on CPS data. D. Chollet and A. Kirk, "Understanding Individual Health Insurance Markets: Structure, Practices, and Products in Ten States" (Washington: AcademyHealth, 1998). The difference may be attributable to the fact that CPS respondents are asked to identify coverage over the entire previous year, whereas SIPP collects data for each of the prior four months.
14. Many findings in this section confirm prior research on individual insurance. For example, Chollet found that rates of individual coverage are higher among adults ages 55-64, the self-employed, part-time and part-year workers, and nonworkers. Chollet also found little variation in individual coverage by income, although her analysis found slightly lower rates among those living below poverty. Chollet, "Consumers, Insurers, and Market Behavior."
15. Because SIPP asks questions every four months, data often cluster at the four-month intervals (the "seam effect"). This may explain why the median spell length is eight months, although 48 percent of spells last less than six months.
16. Prior research on the impact of regulation on insurance enrollment has proved complicated and yielded contradictory results. To draw strong conclusions from our analyses would have required more sophisticated diagnosis of multicollinearity in our individual and small-group reform variables, as states inclined to regulate these markets often pass multiple reform measures.