As the full effects of the Affordable Care Act become clear, policymakers and payers are likely to make changes to how they implement the law, experts and industry insiders say. Health insurers have suggested adding a fifth tier to the insurance plan categories, offering consumers lower premiums and more flexible benefits. States' exchange websites that did not function well will need to be overhauled, and the federal website must have capabilities added, such as the ability to process plan changes due to subscribers' changing life circumstances.

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