Private companies already have had the concept of "insurance exchanges" for years - its called competition between private insurance providers.
If you just want to decouple medical insurance from being provided by employers you could have passed a law declaring it to not be allowed as a compensation benefit. Have the employers pay the same amount that they pay for the insurance benefits to the employees, and let the employees purchase their own insurance, just like their groceries and housing.
The Democratic Party would love to change that as well. Just give them more of your paycheck (most of it), and they will give you bread and water, and government housing....






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