Objectives: The purpose of this paper is to examine the importance of overall market structure and socio-economic conditions of the population on the rate of uninsured among major Metropolitan Statistical Areas (MSAs) in the United States. The impact of increased HMO penetration on the rate of uninsured will also be examined. Data and methods: The data on insurance coverage, socio-demographic factors, and income distribution are extracted from March 1995 through March 1999 Current Population Surveys. Information on economic structure of MSAa is obtained from the Regional Economic Information System (the Bureau of Economic Analysis). Other sources of data were County Business Pattern, Bureau of Census and InterStudy data files. Pooled cross-sectional and time series models were used to analyze the data set. To examine the potential impact of state level health insurance reforms, a policy variable was also introduced as an independent variable. Results and conclusions: Market conditions, socio-economic development, poverty and economic structure appear to affect the rate of uninsured significantly. Reduction in poverty and unemployment rates improve the health insurance coverage but changing structure of the economy, i.e., shift from large to small scale employers and from industrial to service sectors, tends to lower the coverage rates. The impact of HMO penetration on uninsured rate is found to be low implying that expansion of managed care market will not be able to reduce the rate of uninsured in the country significantly.
Learning Objectives: To demonstrate the importance of examining changing economic structure and socio-economic status of the population in explaining health insurance coverage.
Keywords: Health Insurance, Poverty
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.