2014 Elsevier Inc. All rights reserved. State insurance mandates have proliferated since the mid-1970s. The economics of the laws suggest that they should increase insurance premiums, reduce coverage, and lead to greater use of self-insured plans. More generally, they may affect the use and outcomes of services and may influence the take-up of health insurance. The empirical work has been inconsistent. This stems from measurement issues in classifying and aggregating the laws and a failure to account for the nonrandom enactment of laws in the states. The new generation of research uses much more sophisticated techniques and provides greater confidence in the evaluations of how the laws affect behavior.
