Let’s do a simple thought experiment. Let us assume that you are need to buy health insurance on the individual market. We will also assume that there is only a single insurer offering a single network with a common set of benefits across all scenarios. What scenario is best for you of the three below. I will show you the premiums only.
In most markets, the answer is easy — everyone wants Scenario A as it is the lowest price for identical plans.
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In the ACA markets, it depends. It depends on if you receive subsidies or not.
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In the ACA markets, no one should prefer Scenario B as a first choice. If one is subsidized, Scenario C is better. If one is not subsidized, Scenario A is better.
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States and insurers are trying to figure out how file plans that allow for someone to be better off. Ideally, an insurer would be able to offer Scenario C to all subsidized buyers and Scenario A to all unsubsidized buyers. This can be done if the insurer is able to offer significant variation in plan attributes such as offering only on-Exchange/subsidized PPOs and off-exchange HMOs or by significantly varying networks. Benefit design decisions can be made so that the off-exchange plans are relatively low actuarial value with correspondingly higher deductibles/out of pocket maximums. However to do this greatly increases complexity and navigation costs.
So insurers and state regulators will make choices in multi-dimensional space that won’t be optimal on any single attribute.
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Finally had a dry afternoon yesterday, so I could go out & start serious assessment of the various plants that did or did not survive the winter. It is going to take so much work to rip everything out and start over — I want to save as many of my favorite plants as I can, but I’ll have to dig them up one by one before carpet-bombing the myriad invansive weeds and vinca. And even though I’m not exactly looking forward to the task, at least it’s less discouraging than following the Oval Office Occupation and its various noxious pests…
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From the Washington Post, “Stymied by aides, Trump sought out loyalist to curtail special counsel — and drew Mueller’s glare”:
He had just learned that special counsel Robert S. Mueller III’s investigation went beyond Russia’s interference in the 2016 campaign and into the White House — and that Trump himself was now under scrutiny for his actions in office. The next day, he attempted to oust Mueller, only to be thwarted by his White House counsel, according to the special counsel’s report.
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So Trump turned to the one person he could long count on to do his bidding: Corey Lewandowski, his former campaign manager, described by senior White House advisers to investigators as a Trump “devotee.” In a private Oval Office meeting, the president dictated a message he wanted delivered to then-Attorney General Jeff Sessions: that he needed to give a speech announcing he was limiting the scope of the investigation.
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Trump’s efforts to enlist Lewandowski as a back channel to try to curtail the probe, detailed in 10 pages of Mueller’s 448-page report, provides a new window into how far the president went in trying to hold back the special counsel.
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