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But big cost savings can also come if consumers have choices and incentives to hunt for cheaper coverage.
The House also approved changes to teachers' health insurance, requiring the biggest districts to shop for cheaper coverage, a move demanded by Republicans.
Proponents of the new legislation have long argued that these dominant companies could subvert the competitive goals of the exchanges planned for 2014, which are intended to foster new business and cheaper coverage.
The Republicans reject the idea of mandates to spread the cost of care and instead call for ways for people dissatisfied with their insurer to buy cheaper coverage elsewhere.
The main cost-cutting feature — an annual index that would subject more and more plans to the tax and encourage workers and employers to find cheaper coverage — has actually been strengthened.
We'll either have to force insurers to ignore glaring, easily obtainable facts relevant to their business -- and see the numbers of private entrepreneurs prepared to enter the market gradually shrink -- or we'll have to make it illegal for individuals with great genetic results to use and market that information to insurers for cheaper coverage.
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A study published in the journal Health Affairs in October estimated that a mere 5.2 percent of Medicare Part D beneficiaries chose the cheapest coverage that met their needs.
Whether they get insurance from their employer or buy it themselves, workers would receive the same credit, creating an incentive to shop around for the cheapest coverage.
If so, the workers are behaving no differently than the employers who are looking for the cheapest coverage instead of for the best value.
Federal investigators said Tuesday that they had found a sharp increase in health insurance scams by unlicensed companies that offer cheap coverage, collect millions of dollars in premiums from consumers and small businesses, but then refuse to pay claims.
As proper journalism became impossibly expensive and the recycling of PR handouts and pandering to advertisers became an easy option, what had been a marginal feature in our media landscape became a central mountain of cheap coverage about aspirational stuff.
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