Employer Decisions to Self-Insure
Does State Regulation Matter?

Why do some employers decide to self-insure for their health insurance plans while others do not? Are they influenced by the fact that state laws prohibit managed care plans from restricting the employee's choice of provider? What effect would congressional or court-ordered changes to the federal law ERISA have on the future of employer health insurance?

In a new study sponsored by the Health Care Financing and Organization Program of the Robert Wood Johnson Foundation, Gail Jensen and Michael Morrisey use data from the 1990s on employer-sponsored health insurance plans and changes in state health insurance laws to study the effects of state regulation and other market forces on employers' decisions to self-insure. When an employer decides to self-insure for its group health insurance, it foregoes participating in an insurance pool organized through a health insurance company and instead accepts the responsibility of managing its own risks. Under ERISA, self-insured plans are exempt from most state insurance requirements and state premium taxes. The dramatic increase in self-insurance in the early 1990s coincided with the growth of a variety of managed care plans, which varied widely throughout the states

Has the proliferation of state laws targeted at managed care plans motivated employers to self-insure? At this event, Gail Jensen will present findings about state managed care regulation and the expansion of self-insurance among employers. Participants will also discuss the policy implications of these findings.

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About the Author

 

Robert B.
Helms
  • Robert B. Helms has served as a member of the Medicaid Commission as well as assistant secretary for planning and evaluation and deputy assistant secretary for health policy at the U.S. Department of Health and Human Services (HHS). An economist by training, he has written and lectured extensively on health policy and health economics, including the history of Medicare, the tax treatment of health insurance, and compared international health systems. He currently participates in the Health Policy Consensus Group, an informal task force that is developing consumer-driven health reforms. He is the author or editor of several AEI books on health policy, including Medicare in the Twenty-First Century: Seeking Fair and Efficient Reform and Competitive Strategies in the Pharmaceutical Industry.
  • Phone: 2028625877
    Email: rhelms@aei.org
  • Assistant Info

    Name: Catherine Griffin
    Phone: 2028625920
    Email: catherine.griffin@aei.org

 

David
Hyman

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Tuesday, August 06, 2013 | 12:00 p.m. – 1:30 p.m.
Uniting universal coverage and personal choice: A new direction for health reform

Join some of the authors, along with notable health scholars from the left and right, for the release of “Best of Both Worlds: Uniting Universal Coverage and Personal Choice in Health Care,” and a new debate over the priorities and policies that will most effectively reform health care.

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