Xirasagar Sudha, Samuels Michael E, Stoskopf Carleen H, Shrader William R, Hussey James R, Saunders Ruth P, Smith Danielle T
University of South Carolina, Arnold School of Public Health, Department of Health Services Policy and Management, Columbia, SC 29208, USA.
J Health Soc Policy. 2004;19(1):1-35. doi: 10.1300/J045v19n01_01.
States are ranked based on the potential of their small group health insurance reforms to enhance health insurance uptake. Reforms were quantified based on their market impact potential. Five dimensions of reforms were identified, Access Improvement, Premium Reduction, Premium Differential Reduction, Continuity of Coverage, and Enhancing Valued Plan Features. The reform indices representing these dimensions were developed based on document review of state statutes, combined with actuarial judgment to identify and assign scores to market-relevant regulations in line with their impact potential. The distribution of the states' reform scores and rankings show wide variation in the depth and focus of their reforms. Only seven of the top ten states on the Total Reform index had consistently higher scores on two or more reform dimensions. The conceptual linkages between specific regulations and the documented small group market problems lead to normative expectations of an association between the depth of state reforms and the prevalence of uninsurance.
各州根据其小团体医疗保险改革在提高医疗保险参保率方面的潜力进行排名。改革根据其市场影响潜力进行量化。确定了改革的五个维度，即改善参保机会、降低保费、减少保费差异、保险覆盖连续性以及增强有价值的计划特征。代表这些维度的改革指数是在对州法规进行文件审查的基础上制定的，并结合精算判断，根据市场相关法规的影响潜力对其进行识别和评分。各州改革得分和排名的分布显示出其改革深度和重点存在很大差异。在总体改革指数排名前十的州中，只有七个州在两个或更多改革维度上一直获得较高分数。具体法规与记录在案的小团体市场问题之间的概念联系导致了对州改革深度与未参保率之间关联的规范性预期。
