What are the effects of state health reforms? Researchers at the Bowman Gray School of Medicine evaluated insurance market reforms in 12 states. The effects within a single carrier's various lines of business will be compared among carriers within a given state, and these statewide patterns were compared across states. The study consisted of intensive case studies of insurance market reforms and their effects in a non-random sample of six states that have enacted varying reforms, and a less intensive study of an additional six states. The researchers conducted: 1) two rounds of open-ended interviews of key informants; 2) participant observational studies of insurance agents; 3) content analyses of sales literature and news articles; and 4) statistical analyses of archival documents and secondary data. The objective of this study was to inform lawmakers and the public policy community about whether and how these reforms have achieved their multiple purposes or caused negative consequences, as well as about how the reforms might be improved.