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Spring 2009
ISSN 0890-913X
Volume 24, Number 2

The Effect of State Mandates on Health Insurance Premiums

Stephan F. Gohmann, University of Louisville
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/jpe/index.php?action=ajax&rs=GDMgetPage&rsargs[]=Spring2009 5.pdf&rsargs[]=0
TheJournalofPrivateEnterprise24(2),2009,59-73TheEffectofStateMandatesonHealthInsurancePremiumsStephanF.GohmannUniversityofLouisvilleMyraJ.McCrickardBellarmineUniversityAbstractHealthinsurancemandatesrequireinsurerstoprovidecoverageforspecificservices,providers,orillnesses.Thispaperexamineshowstatehealthinsurancemandatesinfluencepremiumsandenrollmentinhealthinsuranceplans.Contrarytopreviousstudiesthatcomparepremiumsacrossstates,weexaminepremiumsforthesameplansincitiesthatlieonstateborders.Byholdingbothplanandpopulationcharacteristicsconstant,weisolatetheimpactofstatemandatesoninsurancepremiums.Somemandatesincreasepremiumsby24percent.Thesehigherpremiumsreduceenrollmentinhealthplansandmayalsoaffectthedecisiontobecomeself-employedortochangejobs.JELCodes:I11,I18Keywords:Healthinsurance;Mandates;PremiumsI.IntroductionStatehealthinsurancemandatesrequireinsurerstoofferpolicyholderscoverageforspecifiedbenefits,providers,orpatientpopulations(Bunce,Wieske,andPrikazsky,2004).Althoughsomeindividualsmaybenefitfromadditionalcoverage,mandatedbenefitsarenotcostless.Thecostsofmandatesarebornebyboththeinsurancecompaniesandtheinsured,andthesecostsarereflectedininsurancepremiums.Abetterunderstandingofhowmandatesaffectcostsmayleadtomoreinformedpolicydecisions.Therecentavailabilityofpremiumdatafromsourcessuchasehealthinsurance.commakesiteasiertostudytheeffectsofstatemandatesoninsurancepremiums.Forexample,New(2006)usesdatafromehealthinsurance.comtoexaminehowvariousstatelawsaffectpremiumsofidenticalhealthplansin36states.Hefindsthat59
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