Potential Health Insurance Reform Options that Build on Affordable Care Act

health insurance

Why start all over again, experts ask?


Earlier this month, experts from the Commonwealth fund website compiled options for healthcare reform that builds upon the Affordable Care Act, better known as ‘Obamacare.’

For many experts, the idea of building on an existing program and its positive attributes is a preferable option to starting anew with a new plan that will take months to fine-tune and approve and cause further dissension.

The complete report is available here.

Reforms that build on the ACA:

  1. ACA Enhanced I: Improves the ACA’s current premium and cost-sharing subsidies and adds a reinsurance program for the individual market to protect insurers against very high claims.
  2. ACA Enhanced II: In addition to the above reforms, this package includes restoration of the ACA’s individual mandate penalty and reversal of the Trump administration’s expansion of short-term, limited-duration plans.
  3. ACA Enhanced III: This package builds on Reform 2 by closing the Medicaid eligibility gap for adults with very low incomes in states that have not expanded their Medicaid program. It also introduces a limited autoenrollment mechanism for most people receiving benefits from the Temporary Assistance for Needy Families (TANF) or Supplemental Nutrition Assistance Program (SNAP) programs.
  4. ACA Enhanced IV: Adds to the reforms in #3 a public plan option and/or a capping of the provider payment rates in private non-group insurance plans.
  5. Universal Coverage I: The first reform plan to achieve universal coverage, this builds on #4 by enabling workers to opt for subsidized nongroup coverage instead of their employer’s insurance plan and introducing a mechanism through which all legal U.S. residents are deemed insured. This reform features a public option in the nongroup market.
  6. Universal Coverage II: Adds to #5 by boosting premium and cost-sharing subsidies further.

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