Way too broad.

In terms of radiographic imaging, they are not trained to perform or interpret

And if private companies want to compete on an unsubsidized basis because they feel like they can do better than the government , have at it. That’s capitalism.

Right now the ins industry has perfected gaming the ACA. So much has changed from 2010. It’s time to solve problems. No politic

Admin costs drop like a rock. And it may be that Medicare could act as the TPA, reducing costs even further But open it up to competition.

CMS can aggregate a network of providers. There is so much money at stake, it’s hard for providers to say no.

They can also negotiate a cash price, that is a percent of Medicare. Most ACA plans are around 140%. They can do that or better because it’s paid quickly.

The TPAs get paid on a per claim basis. They dont make more for denying claims. They don’t make more for doing anything. They get paid for every transaction they process. Their incentive is to be cost effective and treat patients fairly.

CMS works with Third Party Adminstrators (TPA), to process claims according to the ACA standards. They can work with the TPAs to create a variety of plans. The premiums would be the same as after the Premium Tax Credits and paid to the IRS

1. Instead of of pretending insurance companies are taking on insurance risk, the federal government takes on the role of insurer and guarantor of patient OOP.
All providers get paid. People who can’t afford their deductible or coinsurance are covered by the Feds