Now Available
Disparities in State Health Coverage Report

WASHINGTON, January 10 - Only a few states have clear information about their own health insurance market; therefore, no state has been able to understand its experience in the broader context of how these markets are structured and changing in all states. This is one of the findings of a new study, "Mapping State Health Insurance Markets: Structure and Change in the States' Group and Individual Health Insurance Markets," sponsored by The Robert Wood Johnson Foundation's State Coverage Initiatives (SCI) program.

Using data from surveys of commercial insurers and AcademyHealth's Health Insurer Database, the researchers found that between 1995 and 1997:

• Both the group and individual health insurance markets are highly concentrated.
• In both markets, the relative market shares of different types of insurers changed. HMO market share grew and commercial insurers' market share declined.
• As labor markets tightened with full employment, employer coverage edged upward, causing premium volume to grow rapidly in the group market but to slow or decline in the individual market.

"In every state, health insurance markets are changing," says Deborah Chollet, Ph.D., senior fellow at Mathematica Policy Research, Inc., in Washington, D.C. "Insurers are leaving some markets and consolidating in others. Many of these changes appear to be part of normal competition and may ultimately improve the efficiency of health insurance markets, especially in states with unusually large numbers of insurers per capita. However, no state's health insurance market is particularly competitive in an economist's sense; all are concentrated among a few large insurers, and therefore they bear watching."

This report is available on the SCI Web site at www.statecoverage.net/pdf/mapping.pdf. For copies of the report, contact LeAnne DeFrancesco at leanne.defrancesco@academyhealth.org.

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