Hixme Think

Commentary on “5 Big Ideas to Stabilize the Obamacare Marketplaces” – Adding a 6th Idea – access to the Direct-to-Consumer marketplace …

Denny WeinbergDenny Weinberg

Hixme’s CEO responds to this most interesting article in the Fiscal Times publication, with a very big 6th item to add – and this is REALLY BIG…

Picture from The Fiscal Times showing headline: "5 Big Ideas to Stabilize the Obamacare Marketplaces" with picket signs saying "ACA is HERE to STAY"

Before the “Stabilize the Obamacare Marketplaces” case can be closed, it is important that the ENTIRE Direct-to-Consumer marketplace is considered, a market of nearly 20 million Americans, not just the 12 million who purchase each year on the public exchanges. And this is where the 6th BIG IDEA emerges:

6. Encourage employers to provide direct access for each worker and family member to health plans sold in their home zip code. 

Over 2,500 Direct-to-Consumer health policies from over 150 different insurers supply the national market today. Shocked? Its true. Each zip code has its own unique configuration, from national insurers, statewide insurers, regional hospital systems, local HMO’s and more.

Meanwhile, most employers struggle to provide meaningful, local solutions for each worker, regardless of where they live and work. Similarly, most workers recognize that each member of the family has different coverage needs and different preferences.

Traditional employer approaches don’t allow local preferences for each worker and can not allow each family member to pursue the coverage levels and insurer that they prefer. The only marketplace where this is all possible? The Direct-To-Consumer market which can be accessed by any larger employer that seriously does his/her homework and is interested in an incredible new value.

Best of all, since working Americans and their dependents are materially younger and healthier, their participation has a stabilizing impact on marketplaces created from this Direct-To-Consumer industy…a dramatic impact, and an immediate impact.

The Fiscal Times – August 30, 2017 – Link to original article (posted below) “5 Big Ideas”

By Michael Rainey

The Affordable Care Act has made it possible for millions of people to get health care coverage, but there are plenty of problems with the system it created, including rising costs and the loss of insurers in some local markets. As Congress prepares to once again address health care reform this fall, Julie Rovner of Kaiser Health News highlights five “out-of-the-box” ideas that could help improve how the individual market operates:

  1. Allow people into Medicare starting at age 55. A controversial move that some see as a step toward a single-payer system, moving millions of Americans over age 55 into Medicare would lower the average age in the remaining individual market risk pool, producing lower costs and lower premiums.
  2. Allow people to “buy in” to Medicaid. As an alternative to expanding Medicare, offering a buy-in option for Medicaid could have a similar effect of lowering costs in the individual market by improving the risk pool, since Medicaid typically offers better coverage for people with disabilities than private insurance.
  3. Get younger adults off their parents’ insurance. The Obamacare provision allowing young adults up to age 26 to stay on their parents’ health insurance plans has been quite popular, but it means that millions of healthy, low-cost patients are not part of the risk pool. Eliminating the rule would force them into the individual markets, reducing costs for everyone.
  4. Require insurers who participate in other government programs to offer marketplace coverage. The federal government can use its enormous economic influence to push more insurers into the ACA marketplaces.
  5. Let people use HSA contributions to pay health insurance premiums. This would allow policy-holders to use pre-tax dollars to pay their premiums, making coverage more affordable for a wider pool of participants.

As Kaiser Health News notes, all of these ideas are controversial, and none of them are guaranteed to work. But there’s a real need to make changes, and we may have a window of opportunity to make substantial improvements in the coming months.   

screen shot from Kaiser Health News: 5 Outside-the-box ideas for fixing the individual insurance market. 2 people with sign: Medicare for All; Healthcare for All

Image and link from Kaiser Health News


ABOUT THE HIXME THINK BLOG: Authored by one of the gurus of health insurance, Denny Weinberg, postings reflect market trends and the powerful emerging movements toward true portability and personal ownership by workers and their families. Postings follow these emerging trends, driven by consumer ownership of retirement benefits, consolidations by health care institutions, and the stated pro-consumerism goals and actions of the administration, federal agencies and Congress.




Denny Weinberg is a 35 year veteran executive in healthcare financing and operations. Prior to his 4 years as investor and CEO with Hixme, his broad background includes a 20 year tenure CEO of a number of Anthem's largest operating companies. Denny has managed a portfolio of early stage companies in the Health/Medical arena as well as other industries. He has also served as board member, advisor and consultant to both private equity-backed, and publicly traded Blue Chip companies.

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