Fixing the Health Insurance Exchanges



we've had a lot of recent reports about the failing of the health insurance exchanges there are some areas of the country where there are very many insurance companies participating in the exchange recently in 2017 there's been a substantial increase in the insurance premiums at least in some states but there are things that can be done to stabilize the exchanges and we can learn from states that have had successful exchanges like California how to repair them the first thing is we need to make sure that the exchanges are attractive for insurance companies so that more insurance companies participate they need to actually see more people buying insurance so how do we get more people into the exchanges well one thing we can do is to actually improve the marketing of the exchanges keep informing people that they can actually buy insurance that have to buy insurance as part of the mandate and that there are substantial subsidies to help offset the premium price so marketing especially to the twenty percent of Americans who still don't know that they have to have insurance and that there are good subsidies to help them buy insurance a second answer is that we can actually increase the subsidies to individual especially slightly higher income individuals to buy insurance one of the things we've learned is that people with slightly higher income like the median income actually find insurance on the exchange unaffordable because their subsidies don't help them enough so improving the subsidies could help people buy insurance a third approach is that we can help the insurance companies through reinsurance so that they are protected against having super high costs and expensive patients and by risk adjustment so that an insurance company which gets good healthy people doesn't actually profit by doing that they've helped the insurance companies who've attracted sicker patients because of their good services and we balance out the risk pools that would allow it to be more financially advantageous for insurance companies to participate in the exchanges and finally we might think of ways of getting people who are not eligible necessary for the exchanges into the exchanges one thing some states have looked at and actually done is to say that people who are should get Medicaid through the Medicaid expansion they actually get premium support and subsidies to buy insurance in the exchanges this expands the pool of people buying insurance in the exchange and therefore makes it more stable so these four ideas improving the marketing to bring in people who need insurance but haven't bought it improving the subsidies for people to buy insurance helping the insurance companies through re insurance and risk adjustment and finally expanding the pool who are of people who are eligible to buy insurance in the exchanges are all different ways of stabilizing the exchanges and making them thrive you

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