How has small group market reform affected employee health insurance coverage?

Alan C. Monheit, Barbara Steinberg Schone

Research output: Contribution to journalArticlepeer-review

30 Scopus citations


In the early 1990s, over 40 states passed legislation designed to limit a number of exclusionary practices by insurers in the small group market in order to improve the availability and affordability of health insurance to employees in small firms. In this paper, we address the effects of reform on the likelihood that workers are offered insurance, have employment-based coverage, or are policyholders of an employment-based plan. We use differences-in-differences (DD) and differences-in-differences-in- differences (DDD) estimators to evaluate the differential effects of alternative reform measures on high and low risk workers. We generally find little effect of reform on offer rates and find that, in states with the most stringent reform, employment-based coverage and policyholder rates increased for high risk workers relative to low risk workers. Our results also indicate that the effects of reform varied significantly by the extent to which states adopted guaranteed issue.

Original languageEnglish (US)
Pages (from-to)237-254
Number of pages18
JournalJournal of Public Economics
Issue number1-2
StatePublished - Jan 2004

All Science Journal Classification (ASJC) codes

  • Finance
  • Economics and Econometrics


  • Health insurance
  • Small group market reform

Fingerprint Dive into the research topics of 'How has small group market reform affected employee health insurance coverage?'. Together they form a unique fingerprint.

Cite this