Paul Ryan's "Medicare Exchange"
Paul Ryan's "The Path to Prosperity" Budget, March 20, 2012 - pdf
Ryan Budget Plan - "Blueprint for American Renewal," March 23, 2012
"House Sends Mixed Messages on Exchanges," David Nather, POLITICO PRO, April 28, 2012 (subscription only):
"...The exchange repeal bill, sponsored by House Energy and Commerce Committee Chairman Fred Upton (R-Mich.), would get rid of the mandatory funding in the health care law that gives HHS an automatic supply of money for the state exchanges.
"The bill is one of five measures House Republicans have prepared to defund parts of the ACA that are funded through mandatory spending. But the idea of going after exchanges may be hard to explain, given that Ryan and other Republicans have been pitching his Medicare plan as a new approach that would let them, in Ryan’s words, enroll in “the same kind of health care program that members of Congress enjoy.”
"That’s because the private health insurance plans that would be subsidized by Medicare would be offered through a new exchange. According to the budget resolution report language, the plan “would set up a carefully monitored exchange for Medicare plans. Health plans that chose to participate in the Medicare Exchange would agree to offer insurance to all Medicare beneficiaries to avoid cherry-picking and ensure that Medicare’s sickest and highest-cost beneficiaries received coverage.”
"Ryan’s aides said the exchange ideas aren’t comparable, because Medicare beneficiaries have more health care needs than the rest of the population and people under age 65 shouldn’t be lumped together into regulated marketplaces with a narrow range of coverage options.
"In Ryan’s view, a Medicare exchange would work more like existing programs, such as Part D and Medicare Advantage that are aimed at one specific population, while patients in other age groups would be free to have a wider range of health plans than the ACA exchanges would provide. ...."
CCHF COMMENT ON MEDICARE EXCHANGE: The Obama Administration has set up its Exchange office (CCIIO) in the Medicare Administration to siphon off Medicare dollars for the creation of a single Federal Exchange, according to Cato Institute in a video. Obamacare authorizes a federally-run exchange if state refuse to set up state-run exchanges, but did not fund it. They thought (hoped?) that all the states would comply with the "shall...establish" order in law to create their own state exchanges (web portals into a National Exchange architecture).
The feds can't force States to comply. That would be federal commandeering of States, which is unconstitutional. At least 29 states (see image below) are refusing. The administration is seeking $750M to create a federally-run Exchange ("'Exchange' for the Worst," July 30, WSJ).
Thus, Ryan's plan risks supporting Obamacare's national exchange effort, or advancing it. Once a single online federally-run Exchange for Medicare is funded and established for senior citizens in all 50 states to use, the federal government could easily push to make it the sole place for all citizens to buy insurance. The result would be a Single-Seller System --- and a short walk to Single-Payer.