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We use data from 1993 and 1997 employer surveys to assess whether the three largest statewide small-group health insurance purchasing alliances — in California, Connecticut, and Florida — increased coverage in small business. They did not. Specifically, they did not reduce small-group market health insurance premiums, and they did not raise small-business health insurance offer rates. We explore and discuss some reasons why. Alliances do permit employers to offer much greater choice in the number and types of plans; employees are found to take advantage of this wider choice.

Reprinted with permission from Health Affairs, Vol. 20, No. 1, 2001, pp. 154-163. Copyright © 2001 Project HOPE — The People-to-People Health Foundation, Inc.

Originally published in: Health Affairs, January/February 2001, Vol. 20, No. 1, pp. 154-163.

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