Thank you jimK for saying the following statement that I agree with 100%.
I believe that healthcare needs to be universally available. The ACA is a hard fought and well established foundation upon which to build and reach that goal. By enforcing compliance with rules and policies established for Medicare it ensures more of an Apples to Apples comparison of exchange offered plans with limited 'surprises' in what may or may not be covered. Further, it ensures that offerors are competing to structure the details of their plans and to offer a high quality of service in order truly compete with others by offering plans that best address chosen details of implementation and the services provided. For example, if one plan has higher deductibles or co-pays, this can be compared directly with a competitors plan that may cost more but have less out-of-pocket expenses. Let consumers decide. I think this is the best approach for intelligently transitioning to a cost effective universal health care program that best meets the needs of most people.