Evaluating the effect of regulatory prohibitions against risk selection by health status on supplemental insurance ownership in Israel

In Israel, supplemental insurance, which covers services not included in the mandatory basic benefits package, is offered by sick funds and regulated by the Ministry of Health. In 1998, policy regulations were set to eliminate barriers that prevented the ill from purchasing supplemental insurance, thereby increasing equality and risk solidarity. In this paper, we examine whether these regulations have indeed changed the extent of ownership and characteristics of policyholders, using data from surveys conducted in 1995, 1997, 1999, and 2001. The findings indicate that while there were no significant changes between 1995 and 1997, there was a significant increase in ownership among those with poor health status after the new regulations came into effect. We conclude that administrative regulations can influence the structure of supplemental insurance to achieve desired social values, and discuss additional policy options that are currently under debate in Israel to further promote equality and solidarity in this market by increasing accessibility to low income and other underserved populations.