This would involve stronger regulation of insurance firms to force them to offer insurance to everyone, the creation of central exchanges for buying insurance, and subsidies for the poor.Pioneering reforms in Massachusetts have helped win over many liberals to the mandate idea.
Her most important accomplishment there was the creation of Exchange-Traded Funds, which despite initial resistance from the firm's corporate parent became a highly lucrative product.
Many Republican governors, meeting this week in Las Vegas, complained that they lacked the information needed to decide on creation of exchanges.
But with Republicans in many states resisting the creation of exchanges or deterred by the complexity of the task, federal officials are preparing to do the job, with or without assistance from state officials.
The simmering political debate over Mr. Obama's health care law — which includes an expansion of Medicaid, the government program for low-income people, and the creation of "exchanges" to market subsidized private insurance — makes the work of these foot soldiers more difficult, but also more important.
All at once came massive systemic changes, from the expansion of Medicaid and guaranteed issue to minimum essential benefits and the creation of exchanges.
Will these be sensible, such as rationalizing our myriad, overlapping financial regulatory structures and pushing for the creation of exchanges and clearinghouses for exotic instruments, such as credit default swaps, so we have transparency and standardization?
The Affordable Care Act mandated the creation of exchanges in each state, which will serve as clearinghouses in which private insurance plans can compete for business in a central database as long as they meet certain government-specified criteria, and in which residents can apply for subsidies to lower costs.
The law calls for creation of an exchange in each state and says only government-approved insurance plans can be sold on the exchange.
He wrote an essay advocating the creation of an exchange for sulfur-dioxide emissions.
His health care plan, fighting for survival on Capitol Hill, is grounded in a requirement that individuals buy insurance coverage, creation of an "exchange" marketplace in which policies are sold and subsidies for those who cannot afford them.
