Reply #49: No competition, no cost controls, a captive customer base that cannot even abstain from commerce,

[TheKentuckian]

the same overwhelmed and captured states in charge of regulation, no budgeting for enforcement, anti-trust exemption left firmly in place, no national pool which helps keep the pricing flim-flam going, most people will never have access to the exchanges meaning little market pressure on the system as a whole, the employer based system enshrined but with little obligation since the penalty for dropping coverage is a nothing ass $750, and a key to the treasury for whatever they can't squeeze from the people directly means MISSION ACCOMPLISHED.

And no I wasn't demanding, expecting, or really even daring to hope for single payer nor was I Public Option or bust.
This plan was long ago built from the bottom up to preserve and and secure the insurance cartel as a for profit exclusive gatekeeper not as a means of subduing it.
The plan makes the insurance cartel a too big too fail entity, that is the polar opposite of victory from a systemic point of view and sets an unbounded precedent that the government can demand participation in for profit commerce and worse that the government can dictate we buy from the company store, and that folks is fascism.

The MLR is also likely to be counter-productive because it sets up the cartel to work to push up systemic costs to increase profits and since the rest of the system has no MLR and also desires ever more profits, cost will increase not go down. Plus, the MLR is set where the industry says they are any way so unless they are cooking the books and need to be indicted, it is plausibly and probably meaningless.
This is the cartel's model they are not designed to take the entire flow of the river, they simply divert a percentage into their pockets and play gatekeeper.