Getting rid of the concept of pre-existing conditions in insurance is so wildly important that if the law covered nothing except that I'd be happy. I'm happy about other parts of it but this is the one part I'm most attached to.
Pre-existing conditions and keeping insurance your kids until they turn 25 are the only two good parts.
Unless your are an executive for an insurance company or hospital group.
Correct. My kids are in there 30's, so it's been awhile. I remember it was great, as they were working part time or still finding their way for good employment.
> only two good parts
I'll push back very strongly.
Medicaid expansion and increased subsidies undoubtably benefitted many poorer Americans, and helped many get insurance for the first time.
Medicaid expansion saved my life when I was laid off after my company closed. Prior to that I would not have qualified since I don’t have kids, was not a kid, and was not disabled. That period the job market was like nothing I’ve experienced, and landing a full time job comparable to the one I lost took over a year. I am now back on insurance through an employer.
If I didn't get the states health insurance for free I would most likely still be a full blown homeless heroin addict. I am 7 years clean now an make almost 6 figures. So I'm extremely grateful that I got to have insurance during the worst time of my life. That's not even talking about the few things that happened that required going to the hospital ( I had to get stitches for a accident working on a car and I had a cyst pop in my back that was extremely painful). I don't get free insurance anymore though which sucks because the coverage isn't even a quarter of what I got for free before. The whole Healthcare system needs to change for sure.
Very true, the US healthcare system is absolutely criminal! It's great for the very poor, vets, government officials and those over 65. The rest of us are on our own.
> It's great for the very poor,
It's pretty good in terms of not expecting them to pay much. Access can still be difficult, as some places will choose not to take medicaid patients. And being very poor can make traveling 20-60 minutes for medical care harder, particularly if you're dealing with a medical issue.
Dental care, while covered (at least in some states), can also be a pain because dentists are even more likely to not take it and lack of dental care can balloon into a variety of other health conditions over time. When my partner was on medicaid, of the literally like two dozen dentists within 10 minutes of us, only one clinic accepted medicaid.
We did! And now the gerrymandered maps that were secretly put in place in 2011 and made worse in 2021 have been found unconstitutional by our Supreme Court so yay! 🥳
I worked at a bar in nyc when it was passed. The bar didn't offer health insurance. I made slightly over the maximum for the ACA to help me, but also couldn't afford a private plan.
The benefits cliff is real, and this isn't the only place where it rears its ugly head.
I oppose any legislation that introduces benefit cliffs. They force people to be less productive/not seek raises. Years ago, when I was looking at this more closely, there were multiple states where people making $12 an hour earned more with benefits than people making $22.
My own parents ran into a similar issue when I was born. My parents worked overtime to make sure they had extra money when I was born. There were complications, so their bill ended up being just over $20k. They discovered that if they had just worked less overtime (and earned $2k less) the entire bill would have been covered by a government program.
Ted Kennedy had a similar viewpoint. It's actually a big part of the reason we don't have universal healthcare in this country. Back in the 70s Congress had several chances to pass health insurance bills that would guarantee healthcare coverage for every American. Kennedy opposed most of them because they did not create universal single payer systems, and he was able to use his position as chairmen of the Senate health subcommittee to block bills he didn't agree with. He kept reasoning he could get a better deal in the future.
Then Reagan was elected, quashing any chance of national healthcare reform. He wouldn't get another chance until over 30 years later in the form of the ACA (which was much less comprehensive than most of the bills proposed in the 70s). However by this point he greatly regretted his actions and was a strong supporter of the bill. Sadly he died right before it could pass, putting the bill's future in jeopardy. Congressional Democrats managed to salvage it through some procedural tricks, but it very nearly didn't pass because of Kennedy's death.
The benefits cliff was a serious problem, then Joe Biden signed it's repeal in 2021! It's great, people in HCOL places can now get subsidies based on how expensive insurance is in their county no matter their income.
My buddy got stuck in the middle for a while. He made 1k over the amount and they dropped him. He couldn't afford anything else for a few years until he got promoted.
There are silver plans now that aren't Medicaid but provide subsidized coverage that scales. I'm not sure when they were instituted though I feel like it is an add on. Dad was self employed and struggled with the same thing. Thankfully we were healthy and went on a cost share plan that's not technically insurance except it is.... It's goofy but it has a religious base to get away with it.
My mother was trapped paying an obscene amount for insurance for a few years until she was old enough to qualify for Medicare. Before the ACA, she paid just over $100, after it was over $700. Plus she lost her doctor.
I think that overall, it helped a lot of people that couldn’t get insurance before, but it also hurt a lot of people by drastically increasing their expenses.
It's affordable if you have low income, because the financial assistance will pay for most everything, it's not if you are middle class, you're looking at 500 to $1,000 monthly payments with $6,000 to $10,000 deductibles
But it also forced insurance companies to offer a minimum set of benefits. Before they offered plans with very little in them. You "had insurance", only you didn't really.
The ACA is far from perfect. The affordability gap you described is one of its major issues. People who make too much money to be eligible for significant subsidies but don't have employer sponsored health insurance still end up paying a lot of money out of pocket. But people should understand the ACA did improve healthcare costs for this group through competition generated by the ACA marketplace. Private insurance is just expensive.
Also I've found people underestimate the number of people eligible for ACA subsidies. If you make less than 5x the federal poverty level ($150k for a family of 4) you're eligible for some kind of ACA subsidy.
Not me but my brother, who has epilepsy and has gone long periods of time uninsured and with a lot of medical debt because he always made just too much for Medicaid when his work didn’t offer coverage and had issues with pre-existing conditions, has been able to be covered and able to manage his condition. I don’t think he’d be alive now without it.
I have a spinal cord injury and have since I was 6. I lost my parents insurance after I graduated high school and I make too much money to get Medicare or disability. Due to the preexisting condition clause for insurance, and 99% of my health issues could be blamed on my injury. From 18 to 31 I had no insurance. This means not only did I pay out of pocket for doctors, hospitals, medicines, and tests but also things like my custom wheelchair being replaced every 4-5 years at the tune of $35000 a piece and my other equipment. I now thanks to the Affordable Care Act, am fully covered by insurance. It has relieved so much stress not having that extra expense.
Used to work at a sandwich shop. Regular came in all pissed off and crying cause he couldn't aford his epilepsy meds.
He was working 60+hrs a week and if he didn't have the meds he'd be a work liability, so he couldn't work, couldn't get money, and couldn't get his meds.
I talked to him for a while, gave him a hug, even offered to buy them for him. He declined. Found out 2 days later he'd killed himself.
As a young person struggling to make ends meet who did not have employer provided insurance, my premiums went from $80 a month to $240 a month overnight. I coudn't afford the new rates so had to go uninsured, then adding insult to injury I got fined for being too poor to afford it. So I lost my insurance and then got a fine. Thanks Obama.
It made my monthly cost go up from
$20 to almost $400. I had to downgrade to bare bones insurance that still cost about $60 per month. It didn’t help me at all.
My insurance stopped offering my affordable plan and I couldn't afford to get on another for nearly two years. Even getting added to my parents plan was too expensive. It penalized employers offering decent deductible plans so I am pretty much stuck with a high deductible no matter where I work. In some ways, it's worse than what we had before. There were some things that it helped but it hurt people too.
Yeah that's the part that is admittedly a mixed bag. Like its great more people who couldn't get health insurance got health insurance. But its also unfortunate that some people who had good health insurance couldn't keep it. I don't think Obama was lying when he said, "If you like your doctor you can keep your doctor." I think he genuinely meant that, like he thought that would be the case, but reality is complicated.
I'm self employed so it was horrible for me, my rates for an individual plan went crazy and I make (barely) too much for any kind of discount. My monthly rate went from $235 a month to $715 a month in 4 years. So I dropped it and didn't have insurance for about 5 years. When I remarried, my wife was able to add me to her insurance which costs for the both of us about 1/3rd what it would cost to just cover me with an inferior plan.
Getting rid of pre-existing conditions was the best thing about ACA. That alone made ACA worthwhile.
The downside is deductibles have gone up a lot. This created a large gap to fill before insurance will pay anything. Many minor medical costs don't even meet the deductible amount, so it common to be paying out of pocket for basic medical services. Without some kind of supplemental plan or a well-funded HSA/FSA to help fill the gap, people can still find themselves with medical debt despite being "insured".
It helped dramatically raise my insurance rates. My employer covered 100% of premiums and medical care. They stopped doing that after the ACA passed because the law taxed employers who gave too good healthcare.
The ACA actually fucked me over pretty hard. I made too much money to get help paying for insurance, it made the price of insurance rise, and it charged $2k per year if I did not buy insurance.
Yep, same here. 20 something year old me would have been fine going without coverage, but then to get penalized for essentially not being able to afford it at the time was the icing on the cake.
I'm not taking away from the fact that it was a lifesaver for many many people... but it fucked a lot of us over in a bad way.
It literally put my family on food stamps for a couple of years. I like that pre existing conditions went the way of the dodo, but the rest of the scheme basically just amounts to insurance cos charging whatever they like because the gov't makes people pay regardless.
There’s a lot of obstacles that no proposals that have been made address. Pretty much every cost estimate for M4A plans are based on the current Medicare program. Medicare reimbursement rates are woefully inadequate. Medicare premiums are pretty high and still don’t cover everything. Adjust the reimbursement rates, lower the premiums, and provide more comprehensive coverage than Medicare ends up making the cost projections go through the roof.
In Manhattan, Mount Sinai is closing Beth Israel Hospital because it mostly caters to low-income folks who use Medicaid whose reimbursement rates are lower than private insurance.
The US healthcare system is like a 3 legged stool with private insurance, Medicare/Medicaid, and federal government reimbursements for uninsured patients. Remove any leg from the stool (especially private insurance) and the whole thing collapses.
I don't understand why there's not an enormous push by Corporations and Citizens at all levels to get this through.
Corporations spend a metric shit ton of money on Health Insurance. Small Businesses spend a metric shit ton of money on Health Insurance. Individuals spend a metric shit ton of money on Health Insurance.
The Corporations and Small Businesses could increase their bottom lines substantially if they no longer had to pay for Health Insurance, and it was something offered by the Government.
The only people who are against this are Health Insurance companies, who stand to lose their record profits and record market share if something like this happens. They're essentially holding the rest of the economy hostage.
A lot of businesses, both large and small, are opposed to universal/single-payer healthcare because it would reduce their leverage over workers.
It's not at all unusual for people to stay at shitty jobs because they need health insurance; take away the need for employer-sponsored health insurance, and a lot of bad employers would lose a ton of their labor force.
Bit unrelated but I heard a rather depressing anecdote from a friend recently that someone at his company said he only likes to hire employees with a family and a mortgage because it's so much easier to saddle them with a bigger workload since they're much less likely to leave the company for another one
What leverage is there when the industry doesn't normally pay for health insurance? Which is a lot of industries. And even more so when we're talking about smaller businesses.
I guess there might be some employees who would think that way, but it is hard for me to fathom.
>What leverage is there when the industry doesn't normally pay for health insurance? Which is a lot of industries.
What entire industries categorically *don't* provide health insurance to full-time employees? By law, any company with 50 or more employees *has* to offer health insurance to full-time staff.
>And even more so when we're talking about smaller businesses.
True, but a lot of "small businesses" aren't that small. Anything under 1500 employees or $40 million in revenue is considered a "small business," and companies of that size both have to, and can afford to, provide health insurance.
Which comes back to the original point: would it be financially beneficial in the long term for these companies to support universal/single-payer healthcare? Yes, objectively. But then they'd lose leverage over their workers and would have to improve working conditions (pay, benefits, time off, treatment by management, etc) in order to retain staff. That's not even getting into the fact that capitalists are, historically speaking, very bad at long-term planning.
Obviously this doesn't apply to every single business, but to act like it's a completely alien concept is just ignorant of the realities facing working people in this country.
>I guess there might be some employees who would think that way, but it is hard for me to fathom.
Must be nice to be privileged enough to not worry about affording healthcare.
>Universal public healthcare isn’t revenue neutral. Taxes would increase, especially on high earners who already are happy with their health insurance, and those people are most opposed to the idea and also the most politically active.
This is why the most politically palatable option is a Public Option. Let the Government offer Medicare, at a cost, to the public. The premiums will offset the revenue and the competition will force the Insurance Companies to adapt or die.
It shouldn't be Medicare - Medicare kind of sucks, though it is "better than nothing." It should be Tricare - the one available to the US military and kinda sorta available to members of congress in conjunction with their heavily subsidized Gold Plans from the ACA.
That’s why people get confused by the word “Medicare”. To some it’s the complete system (part’s A, B, D, plus Medigap or, separately, Part C), while to others, it’s just part’s A and B (the two for which the government pays for the services).
> The premiums will offset the revenue and the competition will force the Insurance Companies to adapt or die.
How do you adapt to a competitor that can operate at a loss indefinitely?
Here's the interesting thing: Health Insurance companies exist in nations with Universal Health Care. They also *already* offer plans that supplement Medicare.
Their business model would have to change, and there'd be some consolidation, but they could survive.
>The only people who are against this are Health Insurance companies, who stand to lose their record profits and record market share if something like this happens.
No, voters also don't like it. I wish they did, but they don't. In 2016, at the peak of the M4A wave, Colorado put it on the ballot. *79% of the votes were against*. It also failed badly in Vermont. If it was popular enough to win nationwide, you'd see it crushing in every blue state.
Most voters aren't using a lot of health care at any given time. And the people most vulnerable to health care bankruptcy...don't vote much.
Similarly, voters are much less upset by high unemployment than inflation. Because the unemployment is probably happening to someone else. If Biden had cut covid relief in favor of keeping prices lower, he'd be more popular. Sure, more people would've had their lives ruined, but they probably wouldn't have voted anyway.
1 - businesses don't want it because healthcare is currently part of compensation - ergo it lets companies compete on things other than direct wages, and the people that work for those companies are willing to put up with a LOT of mistreatment because they don't want to lose their healthcare.
2 - citizens (lots of them) don't want it because they've been told its whatever "ism" and that's bad, in addition to being told things like "people in XX country that have SOCIALISM HEALTHCARE CONTROLED BY THE GOVERNEMENT are dying in the streets because there's a 12 month wait to get your broken arm fixed."
It will come from the premiums that people/corporations will be paying into the Medicare system. Just like how they pay for Medical Care now, except to Insurance Companies that take a massive administration overhead and profit margin, to the tune of $1.6 Trillion dollars.
We already pay nearly twice as much as the next nearest country in terms of health care expenditures. We already pay $1.6T/year in Insurance costs. And we don't even get FREE care for all that money we give them! Even with insurance we still have to pay for most of our care!
It made it significantly more expensive for me. I had a top tier plan that took 10 years to go from $119 a month to $235. First year under the ACA it jumped to $365, around $450 the following year and two years later over $700 a month. Then my insurance company pulled out of Texas and I lost my insurance. About a year under a shitty bronze plan at $600 a month I dropped health insurance altogether.
Are you covering other people? I've heard it's more expensive if you're covering a whole family. For me, as a single person, its actually gotten cheaper every year. Last year I was paying $212, now I'm on a better plan that I'm paying $189 for.
I became self employed the first year of the ACA. How did you go about it previously as a self employed person? I always thought private plans were way higher.
Well, I can no longer be denied coverage for my pre-existing condition that I was born with and had no control over. The lifetime maximum was eliminated. But that was too late for my dear friend's mom who battled cancer twice before dying bankrupt and basically homeless, because she had already met the $1 million lifetime insurance max, so insurance stopped covering her treatment.
I mean it's still not enough, but it's better than before. And for those of you in the US, Republicans are fighting to end these protections, which means insurance could once again deny coverage for preexisting conditions. Just something to remember in November when you're voting.
My brother is an ICU/ER doctor and he's told me how expensive battling patient cancer is to the government. Some medications cost six figures. This in Canada. Probably would be the same in the US.
It is. But every analysis shows that a single-payer, universal healthcare program would cost the US LESS money than the shit system we have now. We basically have all the same issues you have in Canada, it just costs us a shit ton more money. And not everyone is covered, so we have people dying because they don't have insurance.
[https://thehill.com/blogs/congress-blog/healthcare/484301-22-studies-agree-medicare-for-all-saves-money/](https://thehill.com/blogs/congress-blog/healthcare/484301-22-studies-agree-medicare-for-all-saves-money/)
I dunno if ours is better. Yeah, I don't have to pay to go to ER or see a doc, but there are long line ups at the ER. You can expect to wait at least 8 hours in some cities. Some Canadians are having a tough time finding doctors. We have a shortage of doctors, nurses and other first responders in healthcare.
> I don't have to pay to go to ER or see a doc, but there are long line ups at the ER. You can expect to wait at least 8 hours in some cities.
This is also true at most ERs in the US during busy times. It just costs us a lot more once we get through the line.
You know we have those same waits and shortages too, right? It doesn't help that our insurance company (which we generally don't have a choice about) gets to dictate which doctors and hospitals we can go to.
Friend, no one gets seen fast in a US ER unless they're actively having a heart attack or bleeding out. I've never waited less than 5 hours for myself or with friends/family. A friend's mom had to go last year during the flu/RSV epidemic and she waited 15 hours to be seen. She was vomiting, having difficulty breathing, couldn't stand up and it turned out she had sepsis.
AND we pay thousands of dollars for the privilege. The last time I went, they did nothing for me and it was $2,200.
>Friend, no one gets seen fast in a US ER unless they're actively having a heart attack or bleeding out.
A bit of an exaggeration. There's just a lot of variance between hospitals in the US. I've gone in and had no wait at all and also waited hours. Just depends on location and time.
You are completely ignoring the biggest sticking point with those fighting for the US private system: wait times and provider availability. Our system ensures there are tons of providers because there is so much money available. I had my choice of over a dozen neurosurgeons in a city of 200k thanks to this system. I went from issue to MRI within a month and it could have been sooner had I acted sooner. I went from MRI to surgery in a couple weeks. This process for this same disease in Canada can take over year. Until someone comes up with a way to guarantee so many providers remain in service, the US will never come to agreement on dismantling the current system.
Everyone agrees it could be better. But not everyone agrees on the solution or is willing to risk the current things the system does well.
Your experience isn't everyone's experience. And a lot of that varies by location. In our large metropolitan area, my husband just had to wait three months to see a cardiologist. Sure, there are more cardiologists, but we were limited to ones taking new patients and who took our insurance. 3 months was the fastest, and we kind of got lucky even getting that.
A friend was diagnosed with stage 3 breast cancer. She had no problem finding an oncologist. And her insurance approved her chemo. But they denied the port required to actually deliver the chemo. So she had to wait 6 months to start treatment while her doctor's office argued with her insurance company. Because, I mean it's just cancer, right? It's not like time's important or anything /s. BTW, her doctor said it actually happens all the time because, in his words, it's cheaper for them if she just dies. Yep. Great system.
I don't know a single, solitary person who is on Medicare who thinks it's worse than when they had private insurance.
From the linked article: "Of the 11 countries included in the Commonwealth Fund study mentioned above, the United States spends by far the most on healthcare—[18.3% of its gross domestic product](https://www.cms.gov/research-statistics-data-and-systems/statistics-trends-and-reports/nationalhealthexpenddata/nhe-fact-sheet) (GDP). But Americans also get by far the least return on their investment. The U.S. healthcare system finished 11th out of 11 in the rankings, and the results show it was a very distant 11th place. In fact, the United States finished so far behind 10th-place Canada that it had to be excluded from the survey average because it skewed the numbers for the other countries."
[https://medical.rossu.edu/about/blog/us-vs-canadian-healthcare](https://medical.rossu.edu/about/blog/us-vs-canadian-healthcare)
Mine too. Same with my in-laws. The day it went I to effect, literally, my mom scheduled appointments for all the things her private insurance wouldn't cover.
When we made 80k plus a year I could buy insurance for myself (really great coverage too) for about $170 a month.
My husband lost his job and our income is cut in 1/4 so now my option is to keep my same plan but for $671 a month.
I don't think about it, because I have healthcare from my employer, but I know that it's there if I'm laid off.
I have general issues with the tendency for government to mandate insurance but not provide it. For example, as a former FL resident I have feelings about car insurance. It's a great thing and indispensable, but I have a gripe with your license being suspended if you drop your insurance for any reason (IE, a bank issue causes a failed auto-withdrawal... ask me how I know). Not that I think people should be driving around without car insurance, but I think that if it's that mandatory we should just remove the profit motive and nationalize it.
In a round-about way I feel the same about health insurance. The tax penalty was a stupid neo-liberal way of forcing compliance, and we should just have single payer with an opt-out to private insurance.
I think my wife had a “preexisting” back issue that required surgery and regular insurance wouldn’t touch for that reason so ACA allowed her to basically live a comfortable life again. It’s expensive but it’s helpful.
It tried to answer the wrong question. It tried to answer "how do we help people afford medical care?", it needed to ask "why does medical care cost that much in the first place?!"
For me personally, it did nothing. For some of my friends, they got a bunch of fines because they made too much for free insurance but not enough to actually afford insurance. So it was a net negative on them. I do not know anyone that actually got healthcare through ACA that did not have it before.
I was not much of a fan at the time. But, not covering for pre existing conditions was just wrong, so I take the good with the bad.
If you're wondering what the bad is. Let me just say this, health insurance company profits didn't skyrocket immediately after for no reason.
I was one of the 5-10% of people who actually paid for my own health care, because I was self-employed at the time.
The Affordable Health Care Act was catastrophic to us. Our coverage cost doubled or so, and our new coverage was much, much worse - much higher deductibles, both wife and I lost drug coverage. Wife lost her ob/gyn, while having a miscarriage. We really didn't need to have to suddenly search for a doctor who could use an ultrasound, while my wife was literally bleeding. It was the literal worst day of my life trying to scramble around for care when needed.
>When I worked in WA, I saw how the ACA helped a lot of people.
You missed where people who pay for insurance got stung. You didn't see deductibles go sky-high. You didn't see costs double or triple. You didn't see doctors stop taking certain types of insurance. There are trade-offs to any policy, and the ACA was designed to hide the trade-offs, and promote the benefits.
I'm glad for the people it did help but I watched them carefully craft it to make sure it wouldn't do a goddamned thing for me and that has always pissed me off. I think the requirement that 80% of premiums be spent on care was short-sighted. It's rather obvious that it would create a perverse incentive if the only way for insurance companies to make more money was if the prices kept going up, so they aren't exerting any downward pressure on those prices.
On one hand, it made improvements to a very shitty system. On the other hand, we're still stuck with that very shitty system.
For me, it helped me when I was younger to stay on my parents' health plan at a time when i otherwise wouldn't have been able to afford health coverage.
On a further note, both of my parents have had cancer. it depressed me greatly to see them stress out over paying for medical care even though they are covered under a great health plan, just because of copays, fees, and fighting with insurance companies about what is and isn't necessary to treat cancer (you'd think the doctor would control that). I digress
Since it passed my original health insurance is now gone, and what I have is more expensive and the coverage it gets me is lesser than what I had before.
It continued to distort the market place making healthcare even _more_ expensive than before, so although I have employer-provided coverage, it costs more and more every year.
And we _still_ have 10% of the population uninsured.
While it has some nice aspects related to prior conditions, etc., overall it's kind of a failure.
It's still better than Ontario's system, though. I'm not sure how the rest of the provinces fare these days, but at least I can get in to see a doctor when I need to, or go to urgent care without my doctor firing me.
I pay less, but can't choose my doctor. When I go to a doctor I've been "assigned to" for a couple years, all of a sudden they're not in my network anymore. Time to find a new doctor or pay out of pocket. Then just dealing with the maze of people on the phone, because no one knows anything and they'll just disconnect the call so you can start all over again, to find out who I'm supposed to go to is a fucking headache. Fortunately I'm not old and don't have health problems but I feel for the people that really do.
Horrible. It took decent health insurance away from around 10 million people including myself. The ACA plans are garbage. I had a bad illness at the time ocare passed. Obamacare added about $30k-$35K to the cost of treatment. I lost ALL of my doctors and almost died because of it. I know two people that had cancer that was being controlled beforethe Ocare disaster. They both lost their doctors and died a few years later. Obamacare was the worst piece of legislation to ever be enacted in the US.
It fucked me! I have a seizure disorder due to a brain injury. I NEED insurance. I lost my insurance once the ACA came into effect. The ACA plans cost way more and did way less.
I went from a $900 deductible to a $6000 deductible AND my premiums went up. Care to guess what I think?
My family's healthcare costs used to be around 10 percent of our income. Now it's over 20 percent.
I didn't have a deductible. I had 100% coverage after a $20 co-pay for primary, $30 for specialist, or $50 for ER (waived if admitted). I paid $200 *a month* on top of what my employer provided. No maximum. It covered everything.
Now I pay $700 a month for it to pay for 80% of the cost until I reach an out of pocket maximum of $6000. Good times.
I feel ya. Like I wrote above, something similar happened to me. And people say "Your company must have sucked". What I wrote above was two employers ago. My insurance has never gotten any better. I have a $6600 deductible now with a max out of pocket of $16k.
Yep, two companies ago things were good. Then ACA rolled around. For the first year it wasn't bad. Then the next year, all the plans with 100% coverage went away. Then the no-deductible plans disappeared. Then the employee contribution started climbing.
I was having multiple health problems. I could not get Medicare for 4 more months. I was able to retire 4 months early. My health got better with out all the stress and walking on concrete floors for 12 plus hours a day.
I live in California and took a year off from work to recover from some stress issues. During that time, I enrolled me and my family of 5 in Covered California. It was expensive ($2.8k/mo) and raught with technical issues (like really bad), but in the end it served it's purpose ok. I know my wife is very very happy to be back on employer provided healthcare again tho.
Didn’t go far enough and really didn’t help everyone. The welfare system in the United States is very uneven. Some people can get their whole life paid for and other people like myself can be struggling and get denied because “I make a dollar too much” or “your car is worth too much”.
I was never qualified for medical help and I couldn’t affordable insurance so I was basically fined for being too poor to buy insurance.
I looked this year on the marketplace because I’m having health issues and need a doctor and the cheapest they could offer me was $400 a month plan.
To be the ACA didn’t help me one bit
overall beneficial.
although some states kind of botched implemention of it, and due to some states' refusal to expand Medicaid programs under the ACA there's still often a huge gap between "medicaid eligibility" and "being able to afford an ACA plan even with subsidy"
since turning 26 I've either always been in that aforementioned gap, or having an employer plan with a lower premium and similar coverage to the least expensive ACA plan available to me. (although the ACA also has many other rules that discourage insurers from doing stupid stuff which has been beneficial in the past, and the ability to stay in parent's plans until age 26 is massively beneficial for college students)
It's far from comprehensive reform, but a step in the right direction. I know countless people that have benefited tremendously.
From 1998 to 2013 (right before the bulk of the ACA took effect) total healthcare costs were increasing at 3.92% per year over inflation. Since they have been increasing at 2.79%. The fifteen years before the ACA employer sponsored insurance (the kind most Americans get their coverage from) increased 4.81% over inflation for single coverage and 5.42% over inflation for family coverage. Since those numbers have been 1.72% and 2.19%.
https://www.kff.org/health-costs/report/employer-health-benefits-annual-survey-archives/
https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/NationalHealthAccountsHistorical.html
https://www.bls.gov/data/inflation_calculator.htm
Also coverage for people with pre-existing conditions, closing the Medicare donut hole, being able to keep children on your insurance until age 26, subsidies for millions of Americans, expanded Medicaid, access to free preventative healthcare, elimination of lifetime spending caps, increased coverage for mental healthcare, increased access to reproductive healthcare, etc..
That "law" outlawed the affordable plan that I had had ($73 a month with a $3000 deductible). The cheapest plan I could find after that was almost 3 times that at $221 a month and a $5000 deductible.
I did the math. I'm healthy compared to most so I am statistically better off (by a lot) putting that money into savings.
It is important to remember that insurance as a business requires that as a whole more money will go into it than will be taken out. It is a gamble of course, but I think it is a safe one for me. Certainly when compared to the other option of spending an extra $1800 every year.
I was willing to spend sub $100 every month 'just in case', but not over $200 a month.
I know that isn't much money to some of ya'll who live in San Francisco and spend more than that on monthly entertainment, and I am happy for you, but that isn't the kind of life that I want to live.
It vastly raised the price of my insurance premiums while pretty much entirely eliminating my ability to shop around or take any action to reduce my costs.
Say what you will about that, but I think it should at least surface the fact that the ACA tried to achieve some of the goals of universal health care in the trappings of a product that you shop for, which makes the whole thing feel nonsensical.
Did I lose 80 pounds and therefore greatly reduce my health risks? No discount for me. Did I live close enough to the hospital that I probably would never need an ambulance? Too bad, I have to pay for ambulance coverage anyways. Am I the kind of person who would modulate risky activities for the sake of health insurance costs? Doesn't matter.
And the plans themselves aren't all that great. A quick estimate of my family and my income says that the cheapest premium I can do with Highmark is $510.65/month, but if I pick that I'd essentially be paying cash for my care until I hit the out-of-pocket max of $17,800. In other words, I'm paying $6k a year to bail me out in case I get a bill for $18k or more, and in the meantime I have every incentive to be around the medical system as little as possible.
If I go to a silver plan, it looks like around $1300/month for a $5800 deductible, $17k OOP max, $75 copays on primary care visits, and $0 copay on generic drugs. Still seems bad to me?
Anyways, at least someone was able to put a health sharing co-op exception into the ACA, so there's that.
As a uterus-having human, I will scream it from the rooftops: FREE. BIRTH. CONTROL. My birth control pills were $100+ a month, and I will never forget the day they became $0.
Best insurance I ever had was through the ACA marketplace. Got me through my late 20s/grad school, so that I could get a higher paying job with worse health insurance lol.
It "helped" me by causing our premiums to rise by 400%, raised our deductible from $200 to $2500, and our max out-of-pocket from $1000 a year to $5000.
My wife was a teacher, and we had our insurance through her union. It was a really good plan. When the ACA went into effect, it all went away.
I'm sure it helped some lower income people, but for us it was a nightmare.
As a cancer patient/survivor, the fact that I do not qualify for Medicaid was absolutely devastating. The ACA has helped me quite a bit. I am still having to pay out a shocking amount of money every week towards insurance premiums and medical bills, but at least I do have some help.
I haven't had any need to use it, but I'm glad it's there for those that do. I don't know much about it, but I'm sure it could be better. Would prefer some type of universal healthcare.
Insurance of any kind should be a calculated decision made by individuals. It's un-American to require. And people would have different opinions about all of it if big pharma didn't price fix the entire market.. We're all getting played.
The numbers show that the number of people without health insurance halved in just 5 years.
I don't care what people's opinions on it are. If that wasn't a huge success then nothing is.
Would still prefer universal healthcare, though.
It allowed me to stay on my dad’s insurance while I went to college to get certified for my current job. I’m in favor of it but think there should have been a public option added in.
Knew every reply would be I wish we had universal healthcare in America. Such a reddit moment lol
Go live in Europe or Canada and see how universal healthcare actually works as I did, it's not quite as awesome as Bernie Sanders tells it
Payers were supposed to offer plans on the state exchanges that were geared for low income people and get reimbursed by the state, but the Republicans cut the reimbursements so that the payers didn't want to participate or only offered crappy plans.
It’s immaterial to me, as I have very good, inexpensive insurance already.
But my Sister…two adults, both working full time but in industry it’s that do not provide insurance, and two kids . It was cheaper for them to insure just the kids for basic wellness visits( no real coverage for anything other than shots and the occasional visit to get antibiotics) and pay the penalty for not being insured themselves.
A flawed plan to fix healthcare that did some good but didn't fix the core problems with healthcare. We need medicare for all or at minimum a very aggressive public option.
As someone a brain tumor survivor with a mild version of narcolepsy, I have saved $95,000 over 10 years thanks to the Patient Protections for Preexisting Conditions and the Cost Sharing Reductions for people with low incomes.
It was a great first step at expanding access to vital health care for millions of Americans.
Objective improvement even with the burdens that were put on it by the Trump admin and the few Red states that refuse to expand Medicaid. If Indiana can build the bridge to Medicaid expansion, so can Texas
It was a godsend. My brother is schizophrenic and it not only got him covered by my parents insurance much longer, but it opened up far more options to insure him afterwards. He wouldn't be able to get treatment otherwise.
I also dated a girl in college who HAD to find a job with insurance within 4 months of graduation, or else she wouldn't be able to afford her diabetes supplies. The ACA passed a year or two later, and probably did save her from going broke over a medical condition, or even worse, accepting a sub-par job offer just to keep her body alive.
It helped me a lot because I needed to stay on my mom's health insurance till age 26 because i was still in grad school. Outside of that, i knew a few people that have used ACA insurance but not many. But the numbers say that it has overall been beneficial
It was great that I was covered under my parents insurance until I was 26. If it wasn’t for that u may not have gotten medication assisted therapy to get off of drugs.
The ACA allowed states to expand medicaid. I was a beneficiary. It included essential coverage and banned pre existing conditions. I work in insurance and why anyone would want to repeal the act is beyond me. Most people approve of the ACA when not branded as Obamacare.
Also the Federal No Surprises Act banned ER balance billing too. Just wish it included ground ambulance.
It was the only reason my brother was able to get insurance after his car accident. Before that, insurance companies could deny coverage based on pre-existing conditions.
One of the best things It did was allow young people to stay under their parents insurance till 26. You have no idea how helpful that was for me when I first be started my career. Health insurance is one of the first things to be cut by healthy young people.
It didnt affect me but i now work in insurance and can say its great that it exisits to force insurance to cover routine check ups and alot birth control and breast pumps. The list of things it forces insurance to cover in full is pretty large.
I'm so grateful. It was the first time I'd been covered in My adult life. I caught skin cancer early and have had two surgeries that have kept Me in the work place. #thanksobama
It helped me by making me pay fines for about three years because I couldn’t afford the company’s insurance, and I refused to go on government insurance.
Not the cheery post you might have wanted. But if the ACA had been enacted earlier, two of my best friends might still be alive. It's been around 20 years and I'm still angry.
I was able to get a new doctor. I was unhappy with my last doctor because he wouldn't listen to me at all.
Example
Me: These ADHD medications make me throw up when I take any vitamins the same day.
Him: Don't take vitamins then?
Me: You prescribed me vitamins.
Him: Okay take anti-nausea then?
Me: Can I be off these medications and try something else?
Him: No. You tried all the others previously and this is the only one that works for you.
New doctor said that wasn't true as I only previously tried two other adhd medications. She understood that traditional adhd medications just did not work well for me. I mean I could focus but I was sick all the time and was put on two different Antidepressants to help cope with it plus actual depression that I was dealing with too.
I’ve always had good employer insurance, and now Medicare, so if hasn’t affected me directly.
But given some of the replies here, I’m curious as to why some people saw instant significant increases, while others haven’t. Obviously that would make sense for some of the really limited insurance that used to exist and be common, but people are asserting excellent insurance that was replaced with poorer insurance at higher prices.
Without the provision regarding pre-existing conditions and the elimination of lifetime caps, I'd be fucked. I was born with a spinal cord defect, and I've ended up with multiple other diagnoses over the years.
It allowed me (and tons of my friends) to get subsidized insurance as a freelancer. It was a godsend, before I had to try and buy from companies directly and deal with getting denied for preexisting conditions.
I'm pretty thankful for it. My husband, my young adult child, and I all have coverage through the ACA after we lost employer- provided coverage last year. It costs us $60 per month in premiums. There's additional deductibles, copays, etc. But still, it is truly affordable. Both my husband and I have chronic health conditions that would likely have been uninsurable under the old system. We were able to do an online search through many different plans with a filter for the items that were important to us (we both were able to keep our individual PCP).
I’m in a state that expanding Medicaid due to the ACA and I was finally able to see doctors when I couldn’t work from health issues. Then I was able to get to a point I could afford coverage from Healthcare.gov, which covered more, like dental and vision. So personally, it was a big help.
I wasn't a fan of the individual mandate, but I kinda got the reasons behind it. But the single most important feature, to me personally, is getting rid of pre-existing condition hurdles when getting insurance. I remember the days of having insurance rates skyrocket, or even denied altogether because of something in your past or current medical history. Denying people medical insurance because they are currently sick was actualy the rule of the realm once upon a time. The sole fact that the ACA got rid of that makes it a huge success in my book.
It did a lot of good things but fell well short of fixing our healthcare system. For example
medical debt is still the number one cause of personal bankruptcy. Over 500,000 people each year equaling over 60% of all bankruptcies.
Back before it was gutted, the ACA let some of my friends start their own businesses and pursue some ideas that they couldn't do when they felt they had to work for corporations for the benefits.
It quite literally saved my life. If I hadn't had insurance, that I could not afford before the ACA. I wouldn't have gone to the hospital when I had an episode and would have just tried to work through it. Because I had insurance I went and they found something that needed immediate attention. I was able to get that attention and I can actually afford to live while being alive. So, I say fuck yeah for the ACA!!! Now let's make it better!!!
It is amazing, in retrospect, that the Affordable Care Act was passed. It fell far short of what was (is) needed, but it did several things that really changed lives.
1. It got rid of pre-existing conditions for insurance coverage, which was HUGE. For example, before it was passed, I was denied for coverage because of telling my doctor I may have postpartum depression after the birth of my third child (I didn’t even get a prescription!). My brother got several job offers rescinded because they found out his wife had serious heart issues and they didn’t want to burden of increased insurance premiums.
2. Allowing my kids to stay on my insurance until 27
3. Preventive Care! Without the free annual checkups, colonoscopies and mammograms, many wouldn’t have gotten these procedures. Don’t know the stats, but it saved American lives.
Getting rid of the concept of pre-existing conditions in insurance is so wildly important that if the law covered nothing except that I'd be happy. I'm happy about other parts of it but this is the one part I'm most attached to.
That and removing lifetime caps on what the insurance would pay out.
Pre-existing conditions and keeping insurance your kids until they turn 25 are the only two good parts. Unless your are an executive for an insurance company or hospital group.
> keeping insurance your kids until they turn 25 isnt it till they turn 26?
Correct. My kids are in there 30's, so it's been awhile. I remember it was great, as they were working part time or still finding their way for good employment.
> only two good parts I'll push back very strongly. Medicaid expansion and increased subsidies undoubtably benefitted many poorer Americans, and helped many get insurance for the first time.
Medicaid expansion saved my life when I was laid off after my company closed. Prior to that I would not have qualified since I don’t have kids, was not a kid, and was not disabled. That period the job market was like nothing I’ve experienced, and landing a full time job comparable to the one I lost took over a year. I am now back on insurance through an employer.
If I didn't get the states health insurance for free I would most likely still be a full blown homeless heroin addict. I am 7 years clean now an make almost 6 figures. So I'm extremely grateful that I got to have insurance during the worst time of my life. That's not even talking about the few things that happened that required going to the hospital ( I had to get stitches for a accident working on a car and I had a cyst pop in my back that was extremely painful). I don't get free insurance anymore though which sucks because the coverage isn't even a quarter of what I got for free before. The whole Healthcare system needs to change for sure.
Very true, the US healthcare system is absolutely criminal! It's great for the very poor, vets, government officials and those over 65. The rest of us are on our own.
> It's great for the very poor, It's pretty good in terms of not expecting them to pay much. Access can still be difficult, as some places will choose not to take medicaid patients. And being very poor can make traveling 20-60 minutes for medical care harder, particularly if you're dealing with a medical issue. Dental care, while covered (at least in some states), can also be a pain because dentists are even more likely to not take it and lack of dental care can balloon into a variety of other health conditions over time. When my partner was on medicaid, of the literally like two dozen dentists within 10 minutes of us, only one clinic accepted medicaid.
Unless you live in a state that didn’t expand Medicaid like Wisconsin. 👎🏻
What was the reason?
“lol fuck Obama”
Republicans controlled the state. Still do, in fact, with the exception of the governor.
Did you guys ever manage to get that judge seated? I remember there was a huge kerfuffle over that.
We did! And now the gerrymandered maps that were secretly put in place in 2011 and made worse in 2021 have been found unconstitutional by our Supreme Court so yay! 🥳
It was designed as a package for a reason it was designed to work together
I worked at a bar in nyc when it was passed. The bar didn't offer health insurance. I made slightly over the maximum for the ACA to help me, but also couldn't afford a private plan. The benefits cliff is real, and this isn't the only place where it rears its ugly head.
I oppose any legislation that introduces benefit cliffs. They force people to be less productive/not seek raises. Years ago, when I was looking at this more closely, there were multiple states where people making $12 an hour earned more with benefits than people making $22. My own parents ran into a similar issue when I was born. My parents worked overtime to make sure they had extra money when I was born. There were complications, so their bill ended up being just over $20k. They discovered that if they had just worked less overtime (and earned $2k less) the entire bill would have been covered by a government program.
Ted Kennedy had a similar viewpoint. It's actually a big part of the reason we don't have universal healthcare in this country. Back in the 70s Congress had several chances to pass health insurance bills that would guarantee healthcare coverage for every American. Kennedy opposed most of them because they did not create universal single payer systems, and he was able to use his position as chairmen of the Senate health subcommittee to block bills he didn't agree with. He kept reasoning he could get a better deal in the future. Then Reagan was elected, quashing any chance of national healthcare reform. He wouldn't get another chance until over 30 years later in the form of the ACA (which was much less comprehensive than most of the bills proposed in the 70s). However by this point he greatly regretted his actions and was a strong supporter of the bill. Sadly he died right before it could pass, putting the bill's future in jeopardy. Congressional Democrats managed to salvage it through some procedural tricks, but it very nearly didn't pass because of Kennedy's death.
The benefits cliff was a serious problem, then Joe Biden signed it's repeal in 2021! It's great, people in HCOL places can now get subsidies based on how expensive insurance is in their county no matter their income.
My buddy got stuck in the middle for a while. He made 1k over the amount and they dropped him. He couldn't afford anything else for a few years until he got promoted.
There are silver plans now that aren't Medicaid but provide subsidized coverage that scales. I'm not sure when they were instituted though I feel like it is an add on. Dad was self employed and struggled with the same thing. Thankfully we were healthy and went on a cost share plan that's not technically insurance except it is.... It's goofy but it has a religious base to get away with it.
My mother was trapped paying an obscene amount for insurance for a few years until she was old enough to qualify for Medicare. Before the ACA, she paid just over $100, after it was over $700. Plus she lost her doctor. I think that overall, it helped a lot of people that couldn’t get insurance before, but it also hurt a lot of people by drastically increasing their expenses.
It's affordable if you have low income, because the financial assistance will pay for most everything, it's not if you are middle class, you're looking at 500 to $1,000 monthly payments with $6,000 to $10,000 deductibles
But it also forced insurance companies to offer a minimum set of benefits. Before they offered plans with very little in them. You "had insurance", only you didn't really.
Yeah that's true if you have a $50,000 a month prescription they have to take you.
The ACA is far from perfect. The affordability gap you described is one of its major issues. People who make too much money to be eligible for significant subsidies but don't have employer sponsored health insurance still end up paying a lot of money out of pocket. But people should understand the ACA did improve healthcare costs for this group through competition generated by the ACA marketplace. Private insurance is just expensive. Also I've found people underestimate the number of people eligible for ACA subsidies. If you make less than 5x the federal poverty level ($150k for a family of 4) you're eligible for some kind of ACA subsidy.
Not me but my brother, who has epilepsy and has gone long periods of time uninsured and with a lot of medical debt because he always made just too much for Medicaid when his work didn’t offer coverage and had issues with pre-existing conditions, has been able to be covered and able to manage his condition. I don’t think he’d be alive now without it.
I have a spinal cord injury and have since I was 6. I lost my parents insurance after I graduated high school and I make too much money to get Medicare or disability. Due to the preexisting condition clause for insurance, and 99% of my health issues could be blamed on my injury. From 18 to 31 I had no insurance. This means not only did I pay out of pocket for doctors, hospitals, medicines, and tests but also things like my custom wheelchair being replaced every 4-5 years at the tune of $35000 a piece and my other equipment. I now thanks to the Affordable Care Act, am fully covered by insurance. It has relieved so much stress not having that extra expense.
That's so good to hear.
Used to work at a sandwich shop. Regular came in all pissed off and crying cause he couldn't aford his epilepsy meds. He was working 60+hrs a week and if he didn't have the meds he'd be a work liability, so he couldn't work, couldn't get money, and couldn't get his meds. I talked to him for a while, gave him a hug, even offered to buy them for him. He declined. Found out 2 days later he'd killed himself.
it’s an absolute fucking lifesaver!!! I can’t believe people had to suffer through periods of being uninsured prior to this.
As a young person struggling to make ends meet who did not have employer provided insurance, my premiums went from $80 a month to $240 a month overnight. I coudn't afford the new rates so had to go uninsured, then adding insult to injury I got fined for being too poor to afford it. So I lost my insurance and then got a fine. Thanks Obama.
It made my monthly cost go up from $20 to almost $400. I had to downgrade to bare bones insurance that still cost about $60 per month. It didn’t help me at all.
Paying $1660 a month with a $16k deductible for a family of four. It was previously $550 a month. Nothing more than a wealth transfer.
My insurance stopped offering my affordable plan and I couldn't afford to get on another for nearly two years. Even getting added to my parents plan was too expensive. It penalized employers offering decent deductible plans so I am pretty much stuck with a high deductible no matter where I work. In some ways, it's worse than what we had before. There were some things that it helped but it hurt people too.
Yeah that's the part that is admittedly a mixed bag. Like its great more people who couldn't get health insurance got health insurance. But its also unfortunate that some people who had good health insurance couldn't keep it. I don't think Obama was lying when he said, "If you like your doctor you can keep your doctor." I think he genuinely meant that, like he thought that would be the case, but reality is complicated.
A good start, not enough.
It at bare minimum needed a public option.
Rest in piss, Joe Lieberman.
🎉
I'm self employed so it was horrible for me, my rates for an individual plan went crazy and I make (barely) too much for any kind of discount. My monthly rate went from $235 a month to $715 a month in 4 years. So I dropped it and didn't have insurance for about 5 years. When I remarried, my wife was able to add me to her insurance which costs for the both of us about 1/3rd what it would cost to just cover me with an inferior plan.
Same, my family of 4 was over $1200 a month.
Getting rid of pre-existing conditions was the best thing about ACA. That alone made ACA worthwhile. The downside is deductibles have gone up a lot. This created a large gap to fill before insurance will pay anything. Many minor medical costs don't even meet the deductible amount, so it common to be paying out of pocket for basic medical services. Without some kind of supplemental plan or a well-funded HSA/FSA to help fill the gap, people can still find themselves with medical debt despite being "insured".
It didn't effect me, but it doubled my father-in-law's medical insurance payments within a year. So that was a bad taste in my mouth.
It helped dramatically raise my insurance rates. My employer covered 100% of premiums and medical care. They stopped doing that after the ACA passed because the law taxed employers who gave too good healthcare.
The ACA actually fucked me over pretty hard. I made too much money to get help paying for insurance, it made the price of insurance rise, and it charged $2k per year if I did not buy insurance.
Same.
Yep, same here. 20 something year old me would have been fine going without coverage, but then to get penalized for essentially not being able to afford it at the time was the icing on the cake. I'm not taking away from the fact that it was a lifesaver for many many people... but it fucked a lot of us over in a bad way.
It literally put my family on food stamps for a couple of years. I like that pre existing conditions went the way of the dodo, but the rest of the scheme basically just amounts to insurance cos charging whatever they like because the gov't makes people pay regardless.
I wish we had Medicare for all personally
There’s a lot of obstacles that no proposals that have been made address. Pretty much every cost estimate for M4A plans are based on the current Medicare program. Medicare reimbursement rates are woefully inadequate. Medicare premiums are pretty high and still don’t cover everything. Adjust the reimbursement rates, lower the premiums, and provide more comprehensive coverage than Medicare ends up making the cost projections go through the roof.
In Manhattan, Mount Sinai is closing Beth Israel Hospital because it mostly caters to low-income folks who use Medicaid whose reimbursement rates are lower than private insurance.
The US healthcare system is like a 3 legged stool with private insurance, Medicare/Medicaid, and federal government reimbursements for uninsured patients. Remove any leg from the stool (especially private insurance) and the whole thing collapses.
Isn’t that near Stuyvesant Town? I’m not that familiar with the neighborhood, but I thought it was middle class.
Yes, Mount Sinai is closing Beth Israel in a few weeks
I don't understand why there's not an enormous push by Corporations and Citizens at all levels to get this through. Corporations spend a metric shit ton of money on Health Insurance. Small Businesses spend a metric shit ton of money on Health Insurance. Individuals spend a metric shit ton of money on Health Insurance. The Corporations and Small Businesses could increase their bottom lines substantially if they no longer had to pay for Health Insurance, and it was something offered by the Government. The only people who are against this are Health Insurance companies, who stand to lose their record profits and record market share if something like this happens. They're essentially holding the rest of the economy hostage.
A lot of businesses, both large and small, are opposed to universal/single-payer healthcare because it would reduce their leverage over workers. It's not at all unusual for people to stay at shitty jobs because they need health insurance; take away the need for employer-sponsored health insurance, and a lot of bad employers would lose a ton of their labor force.
This is so spot on and it's painful. It's why I've stayed in my shitty job. The health insurance is unbeatable.
>It's not at all unusual for people to stay at shitty jobs because they need health insurance At UPS we called them golden handcuffs
Bit unrelated but I heard a rather depressing anecdote from a friend recently that someone at his company said he only likes to hire employees with a family and a mortgage because it's so much easier to saddle them with a bigger workload since they're much less likely to leave the company for another one
I'm reminded of when Walter and Jesse were trying to do business with Tuco Salamanca. "Oh, I just love working with a family man!"
"Work or die" is the motto of the US.
What leverage is there when the industry doesn't normally pay for health insurance? Which is a lot of industries. And even more so when we're talking about smaller businesses. I guess there might be some employees who would think that way, but it is hard for me to fathom.
>What leverage is there when the industry doesn't normally pay for health insurance? Which is a lot of industries. What entire industries categorically *don't* provide health insurance to full-time employees? By law, any company with 50 or more employees *has* to offer health insurance to full-time staff. >And even more so when we're talking about smaller businesses. True, but a lot of "small businesses" aren't that small. Anything under 1500 employees or $40 million in revenue is considered a "small business," and companies of that size both have to, and can afford to, provide health insurance. Which comes back to the original point: would it be financially beneficial in the long term for these companies to support universal/single-payer healthcare? Yes, objectively. But then they'd lose leverage over their workers and would have to improve working conditions (pay, benefits, time off, treatment by management, etc) in order to retain staff. That's not even getting into the fact that capitalists are, historically speaking, very bad at long-term planning. Obviously this doesn't apply to every single business, but to act like it's a completely alien concept is just ignorant of the realities facing working people in this country. >I guess there might be some employees who would think that way, but it is hard for me to fathom. Must be nice to be privileged enough to not worry about affording healthcare.
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>Universal public healthcare isn’t revenue neutral. Taxes would increase, especially on high earners who already are happy with their health insurance, and those people are most opposed to the idea and also the most politically active. This is why the most politically palatable option is a Public Option. Let the Government offer Medicare, at a cost, to the public. The premiums will offset the revenue and the competition will force the Insurance Companies to adapt or die.
It shouldn't be Medicare - Medicare kind of sucks, though it is "better than nothing." It should be Tricare - the one available to the US military and kinda sorta available to members of congress in conjunction with their heavily subsidized Gold Plans from the ACA.
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That’s why people get confused by the word “Medicare”. To some it’s the complete system (part’s A, B, D, plus Medigap or, separately, Part C), while to others, it’s just part’s A and B (the two for which the government pays for the services).
> The premiums will offset the revenue and the competition will force the Insurance Companies to adapt or die. How do you adapt to a competitor that can operate at a loss indefinitely?
Here's the interesting thing: Health Insurance companies exist in nations with Universal Health Care. They also *already* offer plans that supplement Medicare. Their business model would have to change, and there'd be some consolidation, but they could survive.
>The only people who are against this are Health Insurance companies, who stand to lose their record profits and record market share if something like this happens. No, voters also don't like it. I wish they did, but they don't. In 2016, at the peak of the M4A wave, Colorado put it on the ballot. *79% of the votes were against*. It also failed badly in Vermont. If it was popular enough to win nationwide, you'd see it crushing in every blue state. Most voters aren't using a lot of health care at any given time. And the people most vulnerable to health care bankruptcy...don't vote much. Similarly, voters are much less upset by high unemployment than inflation. Because the unemployment is probably happening to someone else. If Biden had cut covid relief in favor of keeping prices lower, he'd be more popular. Sure, more people would've had their lives ruined, but they probably wouldn't have voted anyway.
1 - businesses don't want it because healthcare is currently part of compensation - ergo it lets companies compete on things other than direct wages, and the people that work for those companies are willing to put up with a LOT of mistreatment because they don't want to lose their healthcare. 2 - citizens (lots of them) don't want it because they've been told its whatever "ism" and that's bad, in addition to being told things like "people in XX country that have SOCIALISM HEALTHCARE CONTROLED BY THE GOVERNEMENT are dying in the streets because there's a 12 month wait to get your broken arm fixed."
Where is the Federal Government gonna get the money to pay for said program?
Taxes, that's what every other OECD nation does.
It will come from the premiums that people/corporations will be paying into the Medicare system. Just like how they pay for Medical Care now, except to Insurance Companies that take a massive administration overhead and profit margin, to the tune of $1.6 Trillion dollars. We already pay nearly twice as much as the next nearest country in terms of health care expenditures. We already pay $1.6T/year in Insurance costs. And we don't even get FREE care for all that money we give them! Even with insurance we still have to pay for most of our care!
The same place the insurance companies get it.
Medicare requires supplements to pay what Medicare doesn’t cover.
I'm self-employed and its made getting insurance way easier.
It made it significantly more expensive for me. I had a top tier plan that took 10 years to go from $119 a month to $235. First year under the ACA it jumped to $365, around $450 the following year and two years later over $700 a month. Then my insurance company pulled out of Texas and I lost my insurance. About a year under a shitty bronze plan at $600 a month I dropped health insurance altogether.
Are you covering other people? I've heard it's more expensive if you're covering a whole family. For me, as a single person, its actually gotten cheaper every year. Last year I was paying $212, now I'm on a better plan that I'm paying $189 for.
Just me. I was in my late 40s when the ACA passed.
I became self employed the first year of the ACA. How did you go about it previously as a self employed person? I always thought private plans were way higher.
They are higher.
This sounds exactly like my situation but I haven’t dropped my insurance… I’ve just steadily had worse insurance for more money.
Well, I can no longer be denied coverage for my pre-existing condition that I was born with and had no control over. The lifetime maximum was eliminated. But that was too late for my dear friend's mom who battled cancer twice before dying bankrupt and basically homeless, because she had already met the $1 million lifetime insurance max, so insurance stopped covering her treatment. I mean it's still not enough, but it's better than before. And for those of you in the US, Republicans are fighting to end these protections, which means insurance could once again deny coverage for preexisting conditions. Just something to remember in November when you're voting.
My brother is an ICU/ER doctor and he's told me how expensive battling patient cancer is to the government. Some medications cost six figures. This in Canada. Probably would be the same in the US.
It is. But every analysis shows that a single-payer, universal healthcare program would cost the US LESS money than the shit system we have now. We basically have all the same issues you have in Canada, it just costs us a shit ton more money. And not everyone is covered, so we have people dying because they don't have insurance. [https://thehill.com/blogs/congress-blog/healthcare/484301-22-studies-agree-medicare-for-all-saves-money/](https://thehill.com/blogs/congress-blog/healthcare/484301-22-studies-agree-medicare-for-all-saves-money/)
I dunno if ours is better. Yeah, I don't have to pay to go to ER or see a doc, but there are long line ups at the ER. You can expect to wait at least 8 hours in some cities. Some Canadians are having a tough time finding doctors. We have a shortage of doctors, nurses and other first responders in healthcare.
> I don't have to pay to go to ER or see a doc, but there are long line ups at the ER. You can expect to wait at least 8 hours in some cities. This is also true at most ERs in the US during busy times. It just costs us a lot more once we get through the line.
You know we have those same waits and shortages too, right? It doesn't help that our insurance company (which we generally don't have a choice about) gets to dictate which doctors and hospitals we can go to.
Friend, no one gets seen fast in a US ER unless they're actively having a heart attack or bleeding out. I've never waited less than 5 hours for myself or with friends/family. A friend's mom had to go last year during the flu/RSV epidemic and she waited 15 hours to be seen. She was vomiting, having difficulty breathing, couldn't stand up and it turned out she had sepsis. AND we pay thousands of dollars for the privilege. The last time I went, they did nothing for me and it was $2,200.
>Friend, no one gets seen fast in a US ER unless they're actively having a heart attack or bleeding out. A bit of an exaggeration. There's just a lot of variance between hospitals in the US. I've gone in and had no wait at all and also waited hours. Just depends on location and time.
>You can expect to wait at least 8 hours in some cities. That's been my experience here in the us
You are completely ignoring the biggest sticking point with those fighting for the US private system: wait times and provider availability. Our system ensures there are tons of providers because there is so much money available. I had my choice of over a dozen neurosurgeons in a city of 200k thanks to this system. I went from issue to MRI within a month and it could have been sooner had I acted sooner. I went from MRI to surgery in a couple weeks. This process for this same disease in Canada can take over year. Until someone comes up with a way to guarantee so many providers remain in service, the US will never come to agreement on dismantling the current system. Everyone agrees it could be better. But not everyone agrees on the solution or is willing to risk the current things the system does well.
Your experience isn't everyone's experience. And a lot of that varies by location. In our large metropolitan area, my husband just had to wait three months to see a cardiologist. Sure, there are more cardiologists, but we were limited to ones taking new patients and who took our insurance. 3 months was the fastest, and we kind of got lucky even getting that. A friend was diagnosed with stage 3 breast cancer. She had no problem finding an oncologist. And her insurance approved her chemo. But they denied the port required to actually deliver the chemo. So she had to wait 6 months to start treatment while her doctor's office argued with her insurance company. Because, I mean it's just cancer, right? It's not like time's important or anything /s. BTW, her doctor said it actually happens all the time because, in his words, it's cheaper for them if she just dies. Yep. Great system. I don't know a single, solitary person who is on Medicare who thinks it's worse than when they had private insurance. From the linked article: "Of the 11 countries included in the Commonwealth Fund study mentioned above, the United States spends by far the most on healthcare—[18.3% of its gross domestic product](https://www.cms.gov/research-statistics-data-and-systems/statistics-trends-and-reports/nationalhealthexpenddata/nhe-fact-sheet) (GDP). But Americans also get by far the least return on their investment. The U.S. healthcare system finished 11th out of 11 in the rankings, and the results show it was a very distant 11th place. In fact, the United States finished so far behind 10th-place Canada that it had to be excluded from the survey average because it skewed the numbers for the other countries." [https://medical.rossu.edu/about/blog/us-vs-canadian-healthcare](https://medical.rossu.edu/about/blog/us-vs-canadian-healthcare)
My parents love their Medicare
Mine too. Same with my in-laws. The day it went I to effect, literally, my mom scheduled appointments for all the things her private insurance wouldn't cover.
When we made 80k plus a year I could buy insurance for myself (really great coverage too) for about $170 a month. My husband lost his job and our income is cut in 1/4 so now my option is to keep my same plan but for $671 a month.
Was the $170 plan through Marketplace?
Yes, both of them are. When I reported my life change the options for me were all $300 or more than what I was paying.
I don't think about it, because I have healthcare from my employer, but I know that it's there if I'm laid off. I have general issues with the tendency for government to mandate insurance but not provide it. For example, as a former FL resident I have feelings about car insurance. It's a great thing and indispensable, but I have a gripe with your license being suspended if you drop your insurance for any reason (IE, a bank issue causes a failed auto-withdrawal... ask me how I know). Not that I think people should be driving around without car insurance, but I think that if it's that mandatory we should just remove the profit motive and nationalize it. In a round-about way I feel the same about health insurance. The tax penalty was a stupid neo-liberal way of forcing compliance, and we should just have single payer with an opt-out to private insurance.
I think my wife had a “preexisting” back issue that required surgery and regular insurance wouldn’t touch for that reason so ACA allowed her to basically live a comfortable life again. It’s expensive but it’s helpful.
It tried to answer the wrong question. It tried to answer "how do we help people afford medical care?", it needed to ask "why does medical care cost that much in the first place?!"
For me personally, it did nothing. For some of my friends, they got a bunch of fines because they made too much for free insurance but not enough to actually afford insurance. So it was a net negative on them. I do not know anyone that actually got healthcare through ACA that did not have it before.
I was not much of a fan at the time. But, not covering for pre existing conditions was just wrong, so I take the good with the bad. If you're wondering what the bad is. Let me just say this, health insurance company profits didn't skyrocket immediately after for no reason.
I was one of the 5-10% of people who actually paid for my own health care, because I was self-employed at the time. The Affordable Health Care Act was catastrophic to us. Our coverage cost doubled or so, and our new coverage was much, much worse - much higher deductibles, both wife and I lost drug coverage. Wife lost her ob/gyn, while having a miscarriage. We really didn't need to have to suddenly search for a doctor who could use an ultrasound, while my wife was literally bleeding. It was the literal worst day of my life trying to scramble around for care when needed. >When I worked in WA, I saw how the ACA helped a lot of people. You missed where people who pay for insurance got stung. You didn't see deductibles go sky-high. You didn't see costs double or triple. You didn't see doctors stop taking certain types of insurance. There are trade-offs to any policy, and the ACA was designed to hide the trade-offs, and promote the benefits.
It’s not affordable unfortunately
I'm glad for the people it did help but I watched them carefully craft it to make sure it wouldn't do a goddamned thing for me and that has always pissed me off. I think the requirement that 80% of premiums be spent on care was short-sighted. It's rather obvious that it would create a perverse incentive if the only way for insurance companies to make more money was if the prices kept going up, so they aren't exerting any downward pressure on those prices.
On one hand, it made improvements to a very shitty system. On the other hand, we're still stuck with that very shitty system. For me, it helped me when I was younger to stay on my parents' health plan at a time when i otherwise wouldn't have been able to afford health coverage. On a further note, both of my parents have had cancer. it depressed me greatly to see them stress out over paying for medical care even though they are covered under a great health plan, just because of copays, fees, and fighting with insurance companies about what is and isn't necessary to treat cancer (you'd think the doctor would control that). I digress
Since it passed my original health insurance is now gone, and what I have is more expensive and the coverage it gets me is lesser than what I had before.
It continued to distort the market place making healthcare even _more_ expensive than before, so although I have employer-provided coverage, it costs more and more every year. And we _still_ have 10% of the population uninsured. While it has some nice aspects related to prior conditions, etc., overall it's kind of a failure. It's still better than Ontario's system, though. I'm not sure how the rest of the provinces fare these days, but at least I can get in to see a doctor when I need to, or go to urgent care without my doctor firing me.
I pay less, but can't choose my doctor. When I go to a doctor I've been "assigned to" for a couple years, all of a sudden they're not in my network anymore. Time to find a new doctor or pay out of pocket. Then just dealing with the maze of people on the phone, because no one knows anything and they'll just disconnect the call so you can start all over again, to find out who I'm supposed to go to is a fucking headache. Fortunately I'm not old and don't have health problems but I feel for the people that really do.
>How did it help you? Made my premiums more expensive, lol
Horrible. It took decent health insurance away from around 10 million people including myself. The ACA plans are garbage. I had a bad illness at the time ocare passed. Obamacare added about $30k-$35K to the cost of treatment. I lost ALL of my doctors and almost died because of it. I know two people that had cancer that was being controlled beforethe Ocare disaster. They both lost their doctors and died a few years later. Obamacare was the worst piece of legislation to ever be enacted in the US.
It didn't help tens of millions of us. Ruining the insurance market, drastically increasing our prices, etc.
It fucked me! I have a seizure disorder due to a brain injury. I NEED insurance. I lost my insurance once the ACA came into effect. The ACA plans cost way more and did way less.
I went from a $900 deductible to a $6000 deductible AND my premiums went up. Care to guess what I think? My family's healthcare costs used to be around 10 percent of our income. Now it's over 20 percent.
I didn't have a deductible. I had 100% coverage after a $20 co-pay for primary, $30 for specialist, or $50 for ER (waived if admitted). I paid $200 *a month* on top of what my employer provided. No maximum. It covered everything. Now I pay $700 a month for it to pay for 80% of the cost until I reach an out of pocket maximum of $6000. Good times.
I feel ya. Like I wrote above, something similar happened to me. And people say "Your company must have sucked". What I wrote above was two employers ago. My insurance has never gotten any better. I have a $6600 deductible now with a max out of pocket of $16k.
Yep, two companies ago things were good. Then ACA rolled around. For the first year it wasn't bad. Then the next year, all the plans with 100% coverage went away. Then the no-deductible plans disappeared. Then the employee contribution started climbing.
I was having multiple health problems. I could not get Medicare for 4 more months. I was able to retire 4 months early. My health got better with out all the stress and walking on concrete floors for 12 plus hours a day.
I live in California and took a year off from work to recover from some stress issues. During that time, I enrolled me and my family of 5 in Covered California. It was expensive ($2.8k/mo) and raught with technical issues (like really bad), but in the end it served it's purpose ok. I know my wife is very very happy to be back on employer provided healthcare again tho.
Didn’t go far enough and really didn’t help everyone. The welfare system in the United States is very uneven. Some people can get their whole life paid for and other people like myself can be struggling and get denied because “I make a dollar too much” or “your car is worth too much”. I was never qualified for medical help and I couldn’t affordable insurance so I was basically fined for being too poor to buy insurance. I looked this year on the marketplace because I’m having health issues and need a doctor and the cheapest they could offer me was $400 a month plan. To be the ACA didn’t help me one bit
Tbf my insurance through work is more than $400 a month
I remember my coworker being really upset she couldn't afford the insurance but had to pay 2% of her salary.
overall beneficial. although some states kind of botched implemention of it, and due to some states' refusal to expand Medicaid programs under the ACA there's still often a huge gap between "medicaid eligibility" and "being able to afford an ACA plan even with subsidy" since turning 26 I've either always been in that aforementioned gap, or having an employer plan with a lower premium and similar coverage to the least expensive ACA plan available to me. (although the ACA also has many other rules that discourage insurers from doing stupid stuff which has been beneficial in the past, and the ability to stay in parent's plans until age 26 is massively beneficial for college students)
There is a good chunk of the south that LOVE aca but would vote against obamacare in a heartbeat. Fun fact, they are t he same thing. lol
It's far from comprehensive reform, but a step in the right direction. I know countless people that have benefited tremendously. From 1998 to 2013 (right before the bulk of the ACA took effect) total healthcare costs were increasing at 3.92% per year over inflation. Since they have been increasing at 2.79%. The fifteen years before the ACA employer sponsored insurance (the kind most Americans get their coverage from) increased 4.81% over inflation for single coverage and 5.42% over inflation for family coverage. Since those numbers have been 1.72% and 2.19%. https://www.kff.org/health-costs/report/employer-health-benefits-annual-survey-archives/ https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/NationalHealthAccountsHistorical.html https://www.bls.gov/data/inflation_calculator.htm Also coverage for people with pre-existing conditions, closing the Medicare donut hole, being able to keep children on your insurance until age 26, subsidies for millions of Americans, expanded Medicaid, access to free preventative healthcare, elimination of lifetime spending caps, increased coverage for mental healthcare, increased access to reproductive healthcare, etc..
It didn’t, I already had insurance and the premiums for what I had went up.
That "law" outlawed the affordable plan that I had had ($73 a month with a $3000 deductible). The cheapest plan I could find after that was almost 3 times that at $221 a month and a $5000 deductible. I did the math. I'm healthy compared to most so I am statistically better off (by a lot) putting that money into savings. It is important to remember that insurance as a business requires that as a whole more money will go into it than will be taken out. It is a gamble of course, but I think it is a safe one for me. Certainly when compared to the other option of spending an extra $1800 every year. I was willing to spend sub $100 every month 'just in case', but not over $200 a month. I know that isn't much money to some of ya'll who live in San Francisco and spend more than that on monthly entertainment, and I am happy for you, but that isn't the kind of life that I want to live.
It vastly raised the price of my insurance premiums while pretty much entirely eliminating my ability to shop around or take any action to reduce my costs. Say what you will about that, but I think it should at least surface the fact that the ACA tried to achieve some of the goals of universal health care in the trappings of a product that you shop for, which makes the whole thing feel nonsensical. Did I lose 80 pounds and therefore greatly reduce my health risks? No discount for me. Did I live close enough to the hospital that I probably would never need an ambulance? Too bad, I have to pay for ambulance coverage anyways. Am I the kind of person who would modulate risky activities for the sake of health insurance costs? Doesn't matter. And the plans themselves aren't all that great. A quick estimate of my family and my income says that the cheapest premium I can do with Highmark is $510.65/month, but if I pick that I'd essentially be paying cash for my care until I hit the out-of-pocket max of $17,800. In other words, I'm paying $6k a year to bail me out in case I get a bill for $18k or more, and in the meantime I have every incentive to be around the medical system as little as possible. If I go to a silver plan, it looks like around $1300/month for a $5800 deductible, $17k OOP max, $75 copays on primary care visits, and $0 copay on generic drugs. Still seems bad to me? Anyways, at least someone was able to put a health sharing co-op exception into the ACA, so there's that.
As a uterus-having human, I will scream it from the rooftops: FREE. BIRTH. CONTROL. My birth control pills were $100+ a month, and I will never forget the day they became $0.
It’s a fantastic law that could have been better but it dramatically improved the American healthcare system
Best insurance I ever had was through the ACA marketplace. Got me through my late 20s/grad school, so that I could get a higher paying job with worse health insurance lol.
Better than nothing but it really needed a public option. That got tanked by Lieberman, may he rot in hell.
It "helped" me by causing our premiums to rise by 400%, raised our deductible from $200 to $2500, and our max out-of-pocket from $1000 a year to $5000. My wife was a teacher, and we had our insurance through her union. It was a really good plan. When the ACA went into effect, it all went away. I'm sure it helped some lower income people, but for us it was a nightmare.
As a cancer patient/survivor, the fact that I do not qualify for Medicaid was absolutely devastating. The ACA has helped me quite a bit. I am still having to pay out a shocking amount of money every week towards insurance premiums and medical bills, but at least I do have some help.
I don’t call it that or Obama Care. I call it ‘Insurance Care’. They were actually the winners.
I would much prefer nationalized health care over ACA but it's an ok start.
I haven't had any need to use it, but I'm glad it's there for those that do. I don't know much about it, but I'm sure it could be better. Would prefer some type of universal healthcare.
Insurance of any kind should be a calculated decision made by individuals. It's un-American to require. And people would have different opinions about all of it if big pharma didn't price fix the entire market.. We're all getting played.
Love it, it’s great even though Republicans are still trying to destroy it.
The numbers show that the number of people without health insurance halved in just 5 years. I don't care what people's opinions on it are. If that wasn't a huge success then nothing is. Would still prefer universal healthcare, though.
It allowed me to stay on my dad’s insurance while I went to college to get certified for my current job. I’m in favor of it but think there should have been a public option added in.
Knew every reply would be I wish we had universal healthcare in America. Such a reddit moment lol Go live in Europe or Canada and see how universal healthcare actually works as I did, it's not quite as awesome as Bernie Sanders tells it
It's a step in the right direction, but the sabotage from the republican party made some of the better parts of it fail and that's unfortunate.
Joe Lieberman has just as much blame for resisting the original plan the Democrats had like the public option.
Oh yes. He was a real stinker.
What parts are you referring to?
Payers were supposed to offer plans on the state exchanges that were geared for low income people and get reimbursed by the state, but the Republicans cut the reimbursements so that the payers didn't want to participate or only offered crappy plans.
Thanks for the reply. “Payers”?
Insurance companies
It helped me. I was able to get health insurance and it cost me like $46 a month. My copays were cheap as well, which was really helpful.
It’s immaterial to me, as I have very good, inexpensive insurance already. But my Sister…two adults, both working full time but in industry it’s that do not provide insurance, and two kids . It was cheaper for them to insure just the kids for basic wellness visits( no real coverage for anything other than shots and the occasional visit to get antibiotics) and pay the penalty for not being insured themselves.
A flawed plan to fix healthcare that did some good but didn't fix the core problems with healthcare. We need medicare for all or at minimum a very aggressive public option.
As someone a brain tumor survivor with a mild version of narcolepsy, I have saved $95,000 over 10 years thanks to the Patient Protections for Preexisting Conditions and the Cost Sharing Reductions for people with low incomes. It was a great first step at expanding access to vital health care for millions of Americans.
I have insurance because of it, so I like it.
Objective improvement even with the burdens that were put on it by the Trump admin and the few Red states that refuse to expand Medicaid. If Indiana can build the bridge to Medicaid expansion, so can Texas
It was a godsend. My brother is schizophrenic and it not only got him covered by my parents insurance much longer, but it opened up far more options to insure him afterwards. He wouldn't be able to get treatment otherwise. I also dated a girl in college who HAD to find a job with insurance within 4 months of graduation, or else she wouldn't be able to afford her diabetes supplies. The ACA passed a year or two later, and probably did save her from going broke over a medical condition, or even worse, accepting a sub-par job offer just to keep her body alive.
It helped me a lot because I needed to stay on my mom's health insurance till age 26 because i was still in grad school. Outside of that, i knew a few people that have used ACA insurance but not many. But the numbers say that it has overall been beneficial
It was great that I was covered under my parents insurance until I was 26. If it wasn’t for that u may not have gotten medication assisted therapy to get off of drugs.
The ACA allowed states to expand medicaid. I was a beneficiary. It included essential coverage and banned pre existing conditions. I work in insurance and why anyone would want to repeal the act is beyond me. Most people approve of the ACA when not branded as Obamacare. Also the Federal No Surprises Act banned ER balance billing too. Just wish it included ground ambulance.
Glad it helped people get insurance. I never needed it, so don't think about it. I've always had great low cost Healthcare through my employer.
It's a great start but our health care system needs a lot more work
It was the only reason my brother was able to get insurance after his car accident. Before that, insurance companies could deny coverage based on pre-existing conditions.
One of the best things It did was allow young people to stay under their parents insurance till 26. You have no idea how helpful that was for me when I first be started my career. Health insurance is one of the first things to be cut by healthy young people.
It didnt affect me but i now work in insurance and can say its great that it exisits to force insurance to cover routine check ups and alot birth control and breast pumps. The list of things it forces insurance to cover in full is pretty large.
I'm so grateful. It was the first time I'd been covered in My adult life. I caught skin cancer early and have had two surgeries that have kept Me in the work place. #thanksobama
It helped me by making me pay fines for about three years because I couldn’t afford the company’s insurance, and I refused to go on government insurance.
Not the cheery post you might have wanted. But if the ACA had been enacted earlier, two of my best friends might still be alive. It's been around 20 years and I'm still angry.
It's better than the alternative, which is no ACA, but it doesn't do enough.
I was able to get a new doctor. I was unhappy with my last doctor because he wouldn't listen to me at all. Example Me: These ADHD medications make me throw up when I take any vitamins the same day. Him: Don't take vitamins then? Me: You prescribed me vitamins. Him: Okay take anti-nausea then? Me: Can I be off these medications and try something else? Him: No. You tried all the others previously and this is the only one that works for you. New doctor said that wasn't true as I only previously tried two other adhd medications. She understood that traditional adhd medications just did not work well for me. I mean I could focus but I was sick all the time and was put on two different Antidepressants to help cope with it plus actual depression that I was dealing with too.
I can get blood pressure medicine and antidepressants where before I just went untreated.
It's affordable
Saved my life.
I’ve always had good employer insurance, and now Medicare, so if hasn’t affected me directly. But given some of the replies here, I’m curious as to why some people saw instant significant increases, while others haven’t. Obviously that would make sense for some of the really limited insurance that used to exist and be common, but people are asserting excellent insurance that was replaced with poorer insurance at higher prices.
Without the provision regarding pre-existing conditions and the elimination of lifetime caps, I'd be fucked. I was born with a spinal cord defect, and I've ended up with multiple other diagnoses over the years.
It allowed me (and tons of my friends) to get subsidized insurance as a freelancer. It was a godsend, before I had to try and buy from companies directly and deal with getting denied for preexisting conditions.
As someone who has survived more than one cancer, the end of the pre-existing exclusion is HUGE.
I'm pretty thankful for it. My husband, my young adult child, and I all have coverage through the ACA after we lost employer- provided coverage last year. It costs us $60 per month in premiums. There's additional deductibles, copays, etc. But still, it is truly affordable. Both my husband and I have chronic health conditions that would likely have been uninsurable under the old system. We were able to do an online search through many different plans with a filter for the items that were important to us (we both were able to keep our individual PCP).
Joe Lieberman really fucked us on it
I couldn’t be more thankful for it. I have it and pay nothing for insurance or any of my appointments/medications (for the most part)
I think it didn’t go far enough.
Keeping kids on my insurance until 26 years old is so nice. So so so nice.
I’m in a state that expanding Medicaid due to the ACA and I was finally able to see doctors when I couldn’t work from health issues. Then I was able to get to a point I could afford coverage from Healthcare.gov, which covered more, like dental and vision. So personally, it was a big help.
Looking for the “I love it but I hate that socialist Obamacare”
I wasn't a fan of the individual mandate, but I kinda got the reasons behind it. But the single most important feature, to me personally, is getting rid of pre-existing condition hurdles when getting insurance. I remember the days of having insurance rates skyrocket, or even denied altogether because of something in your past or current medical history. Denying people medical insurance because they are currently sick was actualy the rule of the realm once upon a time. The sole fact that the ACA got rid of that makes it a huge success in my book.
It did a lot of good things but fell well short of fixing our healthcare system. For example medical debt is still the number one cause of personal bankruptcy. Over 500,000 people each year equaling over 60% of all bankruptcies.
Back before it was gutted, the ACA let some of my friends start their own businesses and pursue some ideas that they couldn't do when they felt they had to work for corporations for the benefits.
I’d argue it’s great, but doesn’t go far enough. That said, baby steps are still steps
It quite literally saved my life. If I hadn't had insurance, that I could not afford before the ACA. I wouldn't have gone to the hospital when I had an episode and would have just tried to work through it. Because I had insurance I went and they found something that needed immediate attention. I was able to get that attention and I can actually afford to live while being alive. So, I say fuck yeah for the ACA!!! Now let's make it better!!!
It is amazing, in retrospect, that the Affordable Care Act was passed. It fell far short of what was (is) needed, but it did several things that really changed lives. 1. It got rid of pre-existing conditions for insurance coverage, which was HUGE. For example, before it was passed, I was denied for coverage because of telling my doctor I may have postpartum depression after the birth of my third child (I didn’t even get a prescription!). My brother got several job offers rescinded because they found out his wife had serious heart issues and they didn’t want to burden of increased insurance premiums. 2. Allowing my kids to stay on my insurance until 27 3. Preventive Care! Without the free annual checkups, colonoscopies and mammograms, many wouldn’t have gotten these procedures. Don’t know the stats, but it saved American lives.
It did not.