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Community rating: an idea whose time has come (again).

K Swartz1

  • 1Harvard School of Public Health.

The Journal of American Health Policy
|December 9, 1992
PubMed
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The shift from community rating to experience rating for health insurance has caused significant inequities. Reinstating community rating can correct these market distortions and improve coverage access.

Area of Science:

  • Health insurance economics
  • Public health policy

Background:

  • The U.S. health insurance market has seen a 20-year trend away from community rating towards experience rating.
  • This shift has led to substantial inequities in health insurance availability and affordability.

Purpose of the Study:

  • To analyze the impact of experience rating on health insurance markets.
  • To propose community rating as a solution to market distortions.

Main Methods:

  • Analysis of health insurance rating practices over the past 20 years.
  • Examination of the economic consequences of experience rating for employers and consumers.

Main Results:

  • Experience rating has created extreme inequities in insurance access and affordability.

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  • Employers are increasingly self-insuring to modify benefit plans, exacerbating market issues.

    • Conclusions:

    • A return to community rating is essential to rectify current market distortions.
    • Community rating can promote equitable access to health insurance coverage.