Hillary Clinton's recent proposal to expand Medicare to those 50 and older could disrupt the current structure of the Affordable Care Act and potentially erode state exchanges, according to a post on the New York Times blog The Upshot.
Historically, the Medicare buy-in option--dubbed "Medicare for more" by the Times--has been pitched as a way to compete with private options, using Medicare's large provider network to drive down premiums. But inserting a public option into the state exchange could have a significant impact on the marketplace. In fact, a cheaper option could push more insurers out of the exchanges altogether if those with private plans suddenly switch to Medicare.
Advocates of the policy argue the Medicare-for-more option would pull older, higher risk individuals out of private plans, driving down costs and making private plans more appealing for younger, healthier individuals. But as the post points out, that could backfire if decreased enrollment causes private insurers to reconsider offering individual marketplace plans.
Mixed financial results have already led some insurers to question the viability of ACA plans, although many remain committed to the marketplace thanks to an influx of new members. On top of these concerns, there are lingering questions about how Medicare's high improper payment rate would mix with a buy-in program that could bring in as many as 13 million new beneficiaries.
To learn more:
- read the post
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