身边的经济学·社会常识英语30篇（9）

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批次0039-004：竞争性医疗保险市场中的公共选项设计

A public insurance option competes with private plans only if it operates under identical risk-adjustment rules.
Premiums must reflect actuarial fairness—not political mandates—otherwise adverse selection destabilizes all pools.
Federal subsidies flow to enrollees regardless of plan type, preventing artificial public-option advantage.
Network adequacy standards apply equally, so public plans cannot exclude high-cost specialty providers.
Administrative cost benchmarks are set transparently using Medicare’s verified per-member-per-month figures.
States that adopted this model saw private premiums rise slower than national averages over five years.
However, insurers exited markets where public options lacked sufficient scale to absorb premium volatility.
Regulators now require public plans to publish quarterly financial sustainability reports alongside private filings.
The design succeeds only when it constrains private pricing power without crowding out innovation.
Ultimately, the public option functions not as replacement but as structural benchmark for market discipline.