Group vs. individual health insurance: Time to break down the wall? 

bringing more employer-subsidized purchasers into the individual market could stimulate more innovation and competition among insurers. (Photo: Shutterstock)

The commercial health insurance market traditionally been divided into three segments – individual, small group and large group. A new study from the Commonwealth Fund suggests that removing these boundaries may increase consumer options.

Until recently, many policymakers believed it was important to keep these market borders distinct to prevent opportunistic “border crossings” that exploit regulatory gaps and loopholes. Under the Affordable Care Act, however, the individual vs. small-group distinction is now much less important. It no longer is the case that an employee would receive inferior coverage if relegated to the individual market, nor would an individual encounter a substantially different set of market rules and conditions. The major difference remaining is simply the price of insurance.