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How to fix Obamacare


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It's working reasonably well for most folks, but is too costly for about 2 million folks-- about 10% of participants. If folks could put politics aside, here's a list of fixes. Thoughts?

  • Require all insurers who want to sell in the individual insurance market to offer their plans through the exchange, so they couldn’t cherry-pick individuals outside the exchange (this is an idea championed by Henry Aaron of the Brookings Institution).
  • Reduce the waiting period for those on disability insurance to get Medicare coverage from two years to six months to move some of the very high-cost enrollees out of the individual-market pool.
  • Require any insurer that wants to offer a Medicare Advantage plan in an area also to offer a plan in the marketplace for under-65 enrollees.
  • Have the federal exchange adopt the procedures used by California in actively bargaining with plans instead of acting as a passive clearinghouses.
  • Create a public option for those aged 55-64 clearly identified as an early buy-in to Medicare.
  • Create a second federally run public option for enrollees from 18 to 54.
  • Restore the risk corridor and reinsurance provisions that have expired that were intended to protect exchange plans against adverse selection.


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