Alice Rivlin/The American Square – The basic concept of premium support is to provide beneficiaries with a subsidy to select among comprehensive health plans offered on a regulated exchange. The plans can all be private or can include a public option. The plans must accept all eligible beneficiaries—guaranteeing access and preventing cherry picking—but the plans will be fully compensated for taking care of older or sicker people. The government subsidy will be capped at a predefined level and growth rate, so it is a defined contribution system, but the cap can be changed by law. If this general structure reminds you of the Massachusetts Connector, the subsidies and exchanges created by the Affordable Care Act, or even Medicare Part D, then you get the idea.