Word: planned
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Under the plans from both the House and Senate, these new, government-run, Web-accessible marketplaces for private insurance (along with possibly a public or co-op alternative) could, theoretically at least, make reviewing and purchasing a new health plan as transparent and easy as entering your zip code and clicking your mouse. Certain broad aspects of the exchange concept are widely accepted: the exchanges would put individuals into large risk pools, allowing them to buy health insurance at a significantly lower cost; federal subsidies for individuals too poor to afford insurance on their own would be doled...
...savage critic of big government; he sees the crucial divide in politics as between those who trust the public sector to grow the economy and those who trust "the guy drawing up a business plan on the back of a napkin at Denny's." In an interview, he supported the privatization of Social Security, a constitutional amendment to restrain spending and the right of schools to teach intelligent design. He sees the stimulus as a defining issue, an inexcusable embrace of intergenerational theft that exposed Crist as a Specter-style Republican In Name Only. If the Republican Party is going...
...most controversial detail is who would participate in these exchanges. Both the House and Senate plans would restrict access to small businesses and individuals not eligible for employer-sponsored plans that meet a set of minimum standards for coverage. Plus, while the House plan would at least start with one national exchange, a Senate proposal would allow states to set up their own, and that could create problems from the outset; not only could they take longer to set up, but there is doubt about whether state or regional exchanges would be able to attract enough enrollees to leverage...
Then there's the problem of adverse selection. Under the House plan, the exchange would be the only place private insurers would be allowed to market and sell individual insurance policies. But under the plan from the one Senate committee that has released legislation, insurers could still sell insurance outside the exchanges. This is a recipe for failure, according to Karen Pollitz, a health-policy researcher at Georgetown University. "Anytime you've got competing markets, there is an opportunity for risks to get shifted," she says. (Both the House and Senate plans would allow, but not require, small businesses...
...insurance brokers would have a strong incentive to nudge sicker or older individuals or small groups toward the exchange, skewing the risk pool there and driving up premiums. "You just have to cherry-pick a little bit to be really profitable," says Pollitz. Both the House and Senate plans call for regulations and rules to prohibit this. But, as Jacob Hacker, a health-policy expert at Yale University, puts it, "The real concern comes down to having adequate resources for enforcement. It's one thing to have rules and another thing to make sure insurance companies are abiding by those...