Notes 04-04 - Lecture 17 Individual Mandates/the MA Reform...

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Lecture 17: Individual Mandates/the MA Reform Plan I. Introduction to Individual Mandates a. Simple in theory: if you require people to be covered, get universal coverage b. The devil’s in the details i. Affordability 1. Subsidies a. For whom? b. How big? c. How funded? d. What about those who don’t quite qualify, for whom health insurance is a significant proportion of income? 2. How to set insurance rates? ii. Enforcement 1. How to verify that people have insurance? 2. How to punish if they don’t have insurance? iii. Cost 1. What about cost growth? 2. What’s the total cost of the plan? Who’s paying for it? iv. Pooling mechanism 1. Will you support people continuing to get insurance from their employer? 2. What mechanism available for people without employer coverage? v. Experience Rating 1. Will you allow there to be different premiums by age, gender, health status? vi. What is “insurance”? 1. Cover prescription drugs, vision, dental; should it cover all health services 2. What deductible is too high?
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