Evaluations of health insurance market reforms have tended to neglect the critical role of independent agents, and have failed, so far, to directly observe market behavior. This article reports on an initial attempt to assess the impact of health insurance market reforms through structured contacts with insurance agents. A small employer was trained to contact a stratified random sampling of agents in eight states with varying market rules, to inquire about insurance purchase for a group of three and an individual, under a scenario that presented various elevated risk factors. On the whole, agents of all types appear to be highly compliant with market reform laws. Very few indicated that coverage would be unavailable for the group. However, for a high-risk individual, the degree of regulation did affect agents' responses about insurance availability. Genetic conditions did not appear to impose a substantial barrier to coverage. And, public purchasing cooperatives were seldom mentioned, in contrast with private association plans. Overall, judged by agents' initial responses to inquiries by potential purchasers, insurance market reforms are not hindering access to health insurance, and they may be significantly helping access, at least for those with chronic medical conditions.
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