By NextBestFitConcentrates costly patients in some plans
The approach can leave some plans covering a more costly mix of patients. This matters when payments do not account for those differences and is less serious when risk is shared adequately.
Under your mix of paths
Paths that create or worsen it
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Caused or worsened by these paths
A cost these paths share. Each path's page says how it applies there.
Regulated multi-payer: everyone must have a non-profit or tightly regulated planTens of millions of people have no coverageRejected
Competing plans need strong risk adjustment to prevent avoidance of sick people.
Public option alongside private insuranceTens of millions of people have no coverageRejected
The public plan may attract sicker people, making its coverage more costly.
Keep employer insurance but make it portableJob lock: people stay in jobs to keep insuranceRejected
Moving workers into individual plans may leave individual-market risk pools sicker.