Bill Overview
Title: Health Marketplace for All Act of 2022
Description: This bill permits entities such as self-employed companies and membership organizations to form health marketplace pools to offer large group health insurance plans as a single employer. (In general, large group health plans cover employees of an employer that has 51 or more employees; in some states, large groups are defined as 101 employees or more.) Subject to specified nondiscrimination rules related to preexisting conditions and health status, health marketplace pools must offer plans to all members or employees of the pool on an equal basis. Health marketplace pools are not considered joint employers for the purpose of other federal labor or employment laws.
Sponsors: Sen. Paul, Rand [R-KY]
Target Audience
Population: Small business employees, self-employed individuals, and members of organizations eligible for large group health plans
Estimated Size: 80000000
- The bill allows self-employed individuals and small companies to join together to form large group health insurance pools.
- Large group health insurance plans generally offer more favorable terms than small group or individual market plans, potentially providing cost savings.
- According to the U.S. Census Bureau, there are approximately 30.2 million small businesses in the United States, comprising 99.9% of all U.S. businesses. Many of these businesses may be interested in joining such health marketplace pools.
- Currently, around 16 million people in the U.S. are self-employed. This legislation could potentially provide them access to large group health insurance plans.
- If all self-employed people and small businesses with employees joined such pools, it could impact millions of people globally.
- Moreover, membership organizations with large numbers of individuals interested in joining health marketplaces can also benefit from this act, expanding the potential reach.
Reasoning
- The policy aims to allow self-employed individuals and small businesses to access large group health insurance plans, potentially reducing their insurance costs and improving coverage quality.
- Given the budget constraints and the large target population, not every individual who could benefit will be reached immediately; initial uptake is likely higher among those who are uninsured or underinsured.
- The policy could result in varied impacts depending on current insurance situations, state regulations, and the willingness of entities to form these pools.
Simulated Interviews
Freelance Graphic Designer (Austin, TX)
Age: 35 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 10.0 years
Commonness: 5/20
Statement of Opinion:
- I find my current individual health insurance quite expensive.
- If I could join a larger group, I hope to save on premiums and get better coverage.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 8 | 5 |
| Year 10 | 8 | 5 |
| Year 20 | 7 | 5 |
Owner of a small hardware store (Rural Missouri)
Age: 42 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 20.0 years
Commonness: 7/20
Statement of Opinion:
- I think this policy could give my employees and me access to more affordable and comprehensive health plans.
- Joining a larger pool seems like a beneficial option.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 8 | 6 |
| Year 3 | 8 | 6 |
| Year 5 | 8 | 6 |
| Year 10 | 9 | 6 |
| Year 20 | 9 | 6 |
Tech startup founder (San Francisco, CA)
Age: 28 | Gender: other
Wellbeing Before Policy: 4
Duration of Impact: 5.0 years
Commonness: 3/20
Statement of Opinion:
- I'm currently uninsured, and this could be a game-changer for my personal finances and well-being.
- Finding affordable health insurance in San Francisco is tough.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 4 |
| Year 2 | 7 | 4 |
| Year 3 | 8 | 4 |
| Year 5 | 8 | 5 |
| Year 10 | 7 | 5 |
| Year 20 | 7 | 5 |
Member of a small non-profit organization (Charlotte, NC)
Age: 50 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 10.0 years
Commonness: 4/20
Statement of Opinion:
- I hope this allows us to access better plans with lower deductibles.
- Healthcare costs are a major concern for small organizations like ours.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 7 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 7 | 5 |
| Year 10 | 8 | 5 |
| Year 20 | 7 | 5 |
IT consultant (Boston, MA)
Age: 37 | Gender: male
Wellbeing Before Policy: 7
Duration of Impact: 3.0 years
Commonness: 6/20
Statement of Opinion:
- I already enjoy some benefits by pooling through a membership organization, so this won't affect me much.
- However, it seems like a good step for the future of healthcare accessibility.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 7 |
| Year 2 | 7 | 7 |
| Year 3 | 7 | 7 |
| Year 5 | 7 | 7 |
| Year 10 | 7 | 7 |
| Year 20 | 7 | 7 |
Retired teacher, working part-time as a consultant (Phoenix, AZ)
Age: 60 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 0.0 years
Commonness: 2/20
Statement of Opinion:
- I'm curious if joining a pool would lower my out-of-pocket costs.
- Currently, I am reasonably satisfied but open to better options.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 6 |
| Year 2 | 6 | 6 |
| Year 3 | 6 | 6 |
| Year 5 | 6 | 6 |
| Year 10 | 6 | 6 |
| Year 20 | 6 | 6 |
Independent contractor (New York, NY)
Age: 30 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 10.0 years
Commonness: 5/20
Statement of Opinion:
- I'm spending too much on my individual plan; this could help me save money.
- If the coverage remains good, it's a win-win.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 7 | 5 |
| Year 3 | 8 | 5 |
| Year 5 | 8 | 5 |
| Year 10 | 8 | 5 |
| Year 20 | 8 | 5 |
Head of a small marketing firm (Miami, FL)
Age: 45 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 15.0 years
Commonness: 8/20
Statement of Opinion:
- Reducing health insurance costs for my employees would significantly help my business.
- I am interested in exploring these health marketplace pools.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 7 | 6 |
| Year 5 | 7 | 6 |
| Year 10 | 8 | 6 |
| Year 20 | 7 | 6 |
Self-employed contractor (Seattle, WA)
Age: 58 | Gender: male
Wellbeing Before Policy: 4
Duration of Impact: 10.0 years
Commonness: 4/20
Statement of Opinion:
- My healthcare costs have been a source of stress; any reduction would be a relief.
- This policy seems promising, especially if it can stabilize my expenses.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 4 |
| Year 2 | 6 | 4 |
| Year 3 | 6 | 4 |
| Year 5 | 7 | 4 |
| Year 10 | 7 | 4 |
| Year 20 | 6 | 4 |
Member of a professional guild (Atlanta, GA)
Age: 49 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 5.0 years
Commonness: 10/20
Statement of Opinion:
- If the guild forms a health pool, it should create better options for us.
- I'm curious to see how this policy unfolds in practice.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 6 |
| Year 2 | 6 | 6 |
| Year 3 | 6 | 6 |
| Year 5 | 6 | 6 |
| Year 10 | 6 | 6 |
| Year 20 | 6 | 6 |
Cost Estimates
Year 1: $300000000 (Low: $250000000, High: $350000000)
Year 2: $300000000 (Low: $250000000, High: $350000000)
Year 3: $300000000 (Low: $250000000, High: $350000000)
Year 5: $300000000 (Low: $250000000, High: $350000000)
Year 10: $300000000 (Low: $250000000, High: $350000000)
Year 100: $300000000 (Low: $250000000, High: $350000000)
Key Considerations
- Potential regulatory compliance costs for establishing and monitoring health marketplace pools.
- Health insurance providers might resist pools due to lower premium revenues per enrollee compared to smaller group markets.
- Effects might vary significantly between states depending on existing healthcare regulations and insurance market conditions.