Market Watch: Community Rating and Sustainable Individual Health Insurance Markets in New Jersey

Health Affairs--July/August 2004
Vol. 23, No. 4
July/August 2004
Monheit, A.C., Cantor J.C., Koller, M., and K.S. Fox
pp. 167-75

The New Jersey Individual Health Coverage Program (IHCP) was implemented in 1993; key provisions included pure community rating and guaranteed issue/renewal of coverage. Despite positive early evaluations, the IHCP appears to be heading for collapse. Using unique administrative and survey data, we examined trends in IHCP enrollment and premiums. We found the stability of the IHCP to be fragile in light of improving opportunities for job-related health insurance. We also found that it is retaining high-risk enrollees. Institutional realities and the difficulty of identifying a control group preclude attributing causality to the plan’s pure community rating and open enrollment provisions.

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