Health insurance premiums, in the United States, are high, and have been rising steadily in the past decade. During that same period, the health insurance market has become highly concentrated, due to numerous consolidations in the insurance industry. The critical health policy question is whether there is a link between the two phenomena, such that insurer competition may have an effect on premium growth. The objective of this study is to examine the relationship between the degree of health insurer competition and premium growth for employer-sponsored insurance coverage, in states and metropolitan statistical areas (MSA), between 2010 and 2014. Multiple regressions are used to estimate the relationships, using premium and competition data from the fifty states and District of Columbia, and MSA markets. For the period of the study, the health insurance markets became highly uncompetitive in 32 out of 50 states, and in 38 out of 74 MSAs; and premiums for employer-sponsored coverage grew by an average of 20% in both state and MSA markets. The major finding is that there does not seem to be any relationship between the degree of insurer competition and health insurance premium growth, at either the state or MSA market levels. These results suggest that the degree of insurer competition is not inversely related to premium growth. Other findings are that per capita income, and republican legislative leadership, in geographic markets, significantly affect annual premiums. The study’s findings indicate that competition in health insurance markets may not be the ultimate approach to significantly reduce healthcare premiums.
|Commitee:||Field, Robert, Jankee, Amy|
|School:||University of the Sciences in Philadelphia|
|School Location:||United States -- Pennsylvania|
|Source:||DAI-A 81/10(E), Dissertation Abstracts International|
|Subjects:||Public policy, Economic theory|
|Keywords:||Competition, Health insurer, Metropolitan statistical area, Per capita, Premium growth, State|
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