With nearly 40 percent of counties nationwide at risk of having no insurer on their Affordable Care Act (ACA) exchange next year, a lack of competition for marketplace customers is a concern. Three professors writing in Health Affairs have a potential solution: allowing Medicare fee-for-service and Medicare Advantage to enter the market in counties with fewer than three exchange insurers.

This would ensure all counties would have at least one insurance option available, wrote Gerard Anderson, PhD, director of the John Hopkins Center for Hospital Finance and Management, Yale University political science professor Jacob Hacker, PhD, and Princeton University sociology professor Paul Starr, PhD. Their proposal would limit this participation to areas with fewer than three insurers to limit displacement of private plans.

“Since Medicare already features private plans, it should be used not only to add a Medicare option, but also to expand the range of private options,” they wrote. “Private insurers that offer Medicare Advantage plans in a region should be required to offer such plans within the exchanges as well. Because many more private insurers participate in the Medicare Advantage program than offer coverage in the exchanges, this would substantially increase the number of private insurers in the small group and individual markets.”

The plan would bring some challenges, such as resistance to a public option which had been axed from the ACA before it was signed into low and changing networks within Medicare plans to fit a different set of patients.

Read more about the proposal at the link below: