ABSTRACT
While the tax-law change is the most important part of proposals to get incentives properly aligned in the non-Medicare health economy, several other issues also loom large. One important negative feature of the Affordable Care Act (ACA) is the ranking system for health insurance plans, which both led to the withdrawal of some desirable plans from the market in late 2013 and sets the wrong standard for the future. Expansion of private insurance coverage was one of the primary goals of the ACA. One of the complicating components of the ACA version of exchanges assigned them the role of subsidy dispenser at the state or federal level to expand health insurance to those at 100–400% of the federal poverty line (FPL). As proposed by the ACA, competition can only increase if insurers start offering new products or state insurance commissioners allow out of state offers of health insurance.
