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Providing health insurance for the 45 million Americans without coverage will be one of the leading domestic issues in the next election. Most people who are uninsured do not have the opportunity to purchase coverage through an employer, and have access to coverage only through the individual insurance market. That market has been the subject of controversy. At one extreme it is described as a failed market which must be reformed through extensive regulation or replaced by the expansion of government programs. At the other extreme, it is held out as the best hope for providing cost-effective coverage for the uninsured and many of those now covered through their employers or public programs.

Participants at this health policy discussion will present new research on the actual performance of this important but often misunderstood part of the health-care system. In a new article to be published in Health Affairs in early May, Mark Pauly of the University of Pennsylvania and Bradley Herring of Emory University and the President’s Council of Economic Advisers present new findings on how insurance companies pool risk in the individual market and how various state regulations affect premiums and the degree of coverage. Based on this research, the authors will use these findings to discuss how policymakers might use individual health insurance as a more effective tool to expand coverage.