I was curious how many people would actually be able to use the new exchanges. Some have said that only a small percent would be eligible.
I was very surprised to find that the CBO is estimating that 26 million are projected to use this part of the HCR.
This is very good news and undermines one of the main criticisms, that the exchanges will only be accessible to a small number of people.
The OPM will have the power to control the profit margin, MLR, coverage of these plans.
Currently the OPM runs the exchange for federal employees, and this is akin to what politicians say when they are talking about expanding plans so that citizens would be able to buy the same insurance federal employees have.
The exchanges also must include 'not for profit' options. Presumably some of these options could be public options established by state governments.
The CBO estimated that 26 million people would use these exchanges, much larger than I had guessed.
Here is what they say:
http://cboblog.cbo.gov/?p=446By 2019, CBO and JCT estimate, the number of nonelderly people who are uninsured would be reduced by about 31 million, leaving about 23 million nonelderly residents uninsured (about one-third of whom would be unauthorized immigrants). Under the legislation, the share of legal nonelderly residents with insurance coverage would rise from about 83 percent currently to about 94 percent.
Approximately 26 million people would purchase their own coverage through the new insurance exchanges and there would be roughly 15 million more enrollees in Medicaid and CHIP than is projected under current law. Relative to currently projected levels, the number of people purchasing individual coverage outside the exchanges would decline by about 5 million. The number of people obtaining coverage through their employer would be about 4 million lower in 2019 under the legislation, CBO and JCT estimate.
The proposal would call on OPM to contract for two national or multi-state health insurance plans—one of which would have to be nonprofit—that would be offered through the insurance exchanges. Not as good as the public option which is not as good as single payer but a big step ahead of what we have today - nothing.