Ines Läufer was a DAAD/AICGS Research Fellow in February and March 2013. Her dissertation focuses on the potential of the private individual health insurance market in the U.S. and in Germany to provide an efficient and socially desirable health care system. At AICGS, she will follow current health policy debates in the U.S. and study the reasons for and instruments of regulating the private individual insurance market in the U.S., as introduced by the Affordable Care Act.

In both countries, private individual insurance plays a crucial role for some individuals, particularly those who lack access to group insurance (in the U.S.) or to the statutory health insurance (in Germany). Private individual health insurance markets in both countries seem apparently unable to guarantee protection from high costs and may negatively impact the health care provided. As a result of constantly rising insurance premiums, those who need insurance most (the elderly and high risk conditions) have the most restricted access. The situation has sparked a controversial debate in both the U.S. and Germany about the limitations of the private health insurance market.

In the U.S., the Affordable Care Act constitutes a paradigmatic change in federal health policy: It implements strong and comprehensive regulation of the individual private insurance market, which is considered a vehicle for increasing coverage and reducing the number of uninsured individuals. The tendency toward more state control on health insurers in the U.S. is followed very at­tentively in Germany, where it is repeatedly questioned whether private insurance markets can be indeed an alternative to state run systems.

At AICGS, Ines Läufer studied the reasons for the newly implemented changes in the regulation of private individual health insurance contracts and the instruments introduced by the Affordable Care Act. Special interest was given to issues such as the design of health benefit catalogs, the premium ratings, the time period of health insurance contracts, and the regulation of the demand side, such as the individual mandate. State regulation in those areas shall be compared to current conditions for private health insurers in Germany and their local health policy debate about adequate regulation instruments to determine whether both systems could learn from each other’s experiences.

Upon the completion of her AICGS fellowship, Ines Läufer will write her dissertation as a comparative study of the role of the private individual insurance market within the health care system. This will focus on how an individual market interacts with group insurance and Medicaid in the U.S. as well as statutory health insurance and social welfare in Germany. Finally, her dissertation will examine to what extent the current organization of health delivery impacts the potential for a healthy competitive individual insurance market.

Ines Läufer studied Economics and Sociology at the University of Cologne, Germany and in Lyon, France. In March 2009, she joined the Institute for Economic Policy at University of Cologne as Research Assistant. She also gained experience working at the Federal Ministry of Health and the Max Planck Institute for the Study of Societies.

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