ACA Title 1, Sec. 1312. Consumer choice. “Ugly” – In appropriately limits risk pool for individual and small group market. This section of the ACA inappropriately limits the use of one risk pool for all individual plan members and small employer group members. The way I read this it prohibits offering a “Wellness- oriented” risk pool for individual and small employer groups. That is very bad from my vantage point. We know that working populations that do wellness programming have lower health care costs than those that don’t do wellness. This provisions requires only one risk pool for the two groups or the formation of one risk pool for both populations. Either way this seems to prohibit the formation of a risk pool that requires the individual and or small employer to engage in wellness activity. This section needs to be repealed or eliminated. I believe we want to encourage market forces to support people taking better care of their own health. This provision works in the opposite direction – Bad! The other parts of this section define “qualified individuals”, “qualified health plans” and “qualified employers” and set some basic ground rules for how coverage will be structured in and outside of exchanges. Most of these provisions help extend the “level playing field” but also lock everyone into fixed positions which usually acts to prevent innovation.

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