Gail Jensen, Ph.D.

Gail Jensen, Ph.D., has conducted extensive research on markets for private health insurance in the United States, particularly employer-sponsored group coverage. Jensen has published many studies on the content and changing nature of employer-sponsored health benefits in both small and large businesses. These studies address the scope of corporate health benefits for retirees, the changing views of employers regarding health care reform, and the effects of state insurance regulations on employer insurance offerings.

Jensen and her colleagues, Michael Morrisey, Ph.D., at the University of Alabama at Birmingham and Jon Gabel at the Health Research and Education Trust, recently completed work on a HCFO grant that studied the relationship between state and federal managed care insurance regulations and employers' decisions to self-insure their managed care offerings. Some researchers and policy analysts have speculated that employers tend to self-insure their firms in an effort to circumvent compliance with evolving state mandates on coverage, which may require them to provide generous benefit packages. Jensen's research findings suggest otherwise. The study found that employers are using self-insurance to avoid conflicts in insurance laws across states, rather than to cut costs. A full description of Jensen's findings is available in her HCFO Findings Brief titled State Variation in Insurance Laws a Major Driver of Employers' Self Insurance Decisions.

"It is the disparity in insurance mandates across states, not the level of mandates, that has been burdensome to employers and key to their self-insurance decisions," says Jensen. "For them, coping with heterogeneity in regulation across states appears to be more troublesome than complying with any given state's laws."

In another HCFO-funded research project, Jensen evaluated whether three state initiatives to reform the small group market have made health insurance more available to employees at small firms. The study helped states to understand how their legislative actions affected the small group market and to appreciate the role of various factors in small firms' decisions to sponsor health plans. Jensen has also served as co-principal investigator on a HCFO-sponsored project with Morrisey that examined the relationship of "any willing provider" (AWP) laws to health care costs.

In other research, Jensen is studying older adults' choices for health insurance, specifically, how the choices are made and the resulting consequences. This work encompasses active-worker and retiree coverage offered by employers, individually purchased health insurance, and public coverage. It also addresses the lack of coverage among adults age 55 and older. At many levels, Jensen pursues the implications that managed care has for the near-elderly as they transition into retirement and/or onto Medicare. One of the more intriguing questions that have emerged from this work is how the health status of adults in this age range affects their choice of health plans.

"The near elderly, those ages 55 to 64, present a challenge to private health insurance because of their heterogeneous circumstances and differing insurance needs," maintains Jensen. "While many continue to be employed with active worker coverage, some have been forced from the labor market due to declining health and consequently lose employer-sponsored health insurance, even though they are not yet eligible for Medicare. Others have retired from one career and begun another and are faced with the prospect of purchasing insurance in the individual market. Still others have opted for early retirement and are transitioning to retiree coverage."

The aging baby-boom generation means that this segment of the market will be rapidly growing over the next 20 years. The near-elderly age group will increase by almost 50 percent by 2010 and will comprise 13 percent of the U.S. resident population by 2020, according the U.S. Census Bureau. "They represent an important age group by almost any measure," notes Jensen.

Jensen's research has appeared in the Review of Economics and Statistics, Journal of Health Economics, The Milbank Quarterly, Medical Care, and Health Affairs, among others. She currently serves on the National Advisory Council of the National Institute on Alcohol Abuse and Alcoholism, the Board of Directors of the Michigan Public Health Institute, and is a Fellow of the Employee Benefit Research Institute in Washington, D.C.

A professor at Wayne State University jointly appointed in the University's Institute of Gerontology and Department of Economics, Jensen earned her doctorate in economics from the University of Minnesota in 1986 and has previously held positions in the School of Public Health at the University of Illinois at Chicago, the American Hospital Association, and ABT Associates, Inc.

Selected References:

Jensen, G.A. and M.A. Morrisey. "Are Healthier Older Adults Choosing Managed Care?" The Gerontologist, Vol. 44, No. 1, February 2004, pp. 85-94.

Jensen, G.A., Z. Zhiyuan and T. Yasuhiro. "Medical Care of Overactive Bladder in Elderly Patients," Journal of Aging and Pharmacotherapy, Vol. 13, No.1, 2004, pp. 13-28.

Morrisey M.A., G.A. Jensen and J.R. Gabel. "Managed Care and Employer Premiums," International Journal of Health Care Finance Economics, Vol. 3, No. 2, June 2003, pp. 95-116.

Gabel J.R., Jensen G.A. and S. Hawkins. "Self-Insurance in Times of Growing and Retreating Managed Care," Health Affairs, Vol. 22, No. 2, May/June 2003, pp. 202-10.

Jensen, G.A. and M.A. Morrisey. "Endogenous Fringe Benefits, Compensating Wage Differentials and Older Workers," International Journal of Health Care Finance Economics, Vol. 1, No. 3-4, September-December 2001, pp. 203-26.

Jensen, G.A. and M.A. Morrisey. "Employer-Sponsored Health Insurance and Mandated Benefit Laws," Milbank Quarterly, Vol. 77, No. 4, 1999, pp. 425-59.