While Medicare offered a single, uniform plan based on the sole eligibility criterion of age, the Obamacare exchanges feature thousands of insurance company plans (each with its own premiums, co-pays, etc.) and a system of premium subsidies based on verifying income, family size and immigration status.
As result, Himmelstein and Woolhandler contend, Obamacare overhead costs are expected to run closer to the 13% average of private insurers than to the 2% average achieved by Medicare.
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