State Health Insurance Regulation and Self-Employment Rates After the Great Recession: The Role of Guaranteed Issue Mandates

Abstract

Job lock" studies have found that many people retain full-time work with a large organization to retain large-group coverage (Gruber & Madrian, 2002; U.S. Government Accountability Office [GAO], 2011). 1 Yet state regulations that govern insurance access in the small-and nongroup markets, where the selfemployed can shop for insurance, may create substantial subnational variation in this scenario. State insurance regulations' connections to state-level selfemployment patterns nonetheless remain unclear. Some individual-level studies find self-employment positively linked to state regulations that foster insurance access in the small-and nongroup markets (