What’s wrong with just offering an exchange plan to everyone? Get rid of Medicaid. Get rid of employer mandates. Allow insurance companies to offer the same plan nationwide via the exchanges. Allow states to throw a public option into the ring if they want to.
Subsidize everyone where the second lowest-cost silver plan costs more than x% of income. No top income limit, which gets rid of the subsidy cliff.
In NY, a gold plan ($600 deductible) costs about $500-550 per month in 2017. Medicaid costs the state about $1000 per month per user. It would be cheaper to subsidize everyone fully below a certain income and help them with the copays.
Beautiful thing about NY is that it’s been community rated and guaranteed-issue since the early 1990s. Meaning that you got a fixed price on a specific plan regardless of age, gender, or health status.
Insurance is a misnomer. It should be called health CARE or a health system, designed to cover everyone and keep them healthy.
