The effects of three public interventions on health insurance coverage during the 1990's

My thesis explores three substantial interventions in the health insurance market by federal or state legislatures and the consequences of these interventions on health insurance coverage and health care treatment. All three interventions targeted vulnerable populations and tried to change the purchase of health insurance coverage. In each intervention I identify the population that was targeted by the intervention and evaluate the effect that the intervention had on the health insurance coverage of the targeted population. To identify the pure intervention effect on the targeted population I use a difference-in-difference approach which compares the change over time in health insurance coverage for the targeted population and the changes for a control group. This comparison enables me to identify the net effect of the intervention on health insurance coverage of the targeted population. The three interventions are explored in chapters 2-4.;Chapter 2 identifies the impact of community rating in state non-group health insurance markets on the decision to purchase non-group health insurance throughout the 1990s, the composition of the risk pool emerging from the regulation, and insurer behavior in the form of offering HMO products to partially mitigate the impact of community rating. This chapter is based on joint work by Professor Anthony T. Lo Sasso and myself, which explores how state government regulations affected health insurance coverage and utilization of health care services in the non-group market and the implementation of community rating in some states. Chapter 3 investigates the effect the 1996 welfare reform had on health insurance coverage of children of non-citizens. It disentangles differences in effects of welfare reform on health insurance coverage of children of permanent resident parents and non-permanent resident parents. I find that children of non-permanent-resident parents lost health insurance coverage while changes in coverage for children of permanent-resident parents were not significant. Chapter 4 explores whether the State Children's Health Insurance Program (SCRIP) affected health insurance coverage and the likelihood of a physician visit differently across age-groups. The results suggest that the SCRIP expansion had a very different effect on health insurance coverage on children of different ages.