Buchmueller T C, Jensen G A
Graduate School of Management, University of California, Irvine 92697-3125, USA.
Inquiry. 1997 Fall;34(3):249-63.
State-level insurance reforms designed to make health insurance more accessible for small businesses and their employees have become common in the 1990s. This study examines the effects of small group reform legislation enacted in California in 1993. Using survey data on health benefits in small firms, we look at changes in health insurance coverage that occurred between spring 1993 (just before reform) and spring 1995. Our results indicate that insurance became slightly more affordable and, among businesses with three to nine employees, employer provision increased more than 10 percentage points. Provision was unchanged among larger-sized businesses, however. Managed care penetration increased considerably. We argue that California's competitive health insurance market, which already was dominated by managed care, represented a favorable environment for small group reform. In this context, the modest growth in insurance provision highlights the limited potential of incremental reforms for expanding insurance coverage.
旨在让小企业及其员工更容易获得医疗保险的州级保险改革在20世纪90年代已很常见。本研究考察了1993年加利福尼亚州颁布的小团体改革立法的影响。利用小企业健康福利的调查数据，我们观察了1993年春季（改革前）至1995年春季期间医疗保险覆盖范围的变化。我们的结果表明，保险费用略有降低，在有三至九名员工的企业中，雇主提供保险的比例增加了超过10个百分点。然而，规模较大的企业中这一比例没有变化。管理式医疗的渗透率大幅提高。我们认为，已经由管理式医疗主导的加利福尼亚州竞争性医疗保险市场，为小团体改革提供了有利环境。在此背景下，保险提供方面的适度增长凸显了渐进式改革在扩大保险覆盖范围方面的有限潜力。
