1. A while ago, as a somewhat pointed quip, I started pointing out that in the U.S., for health insurance we pay "whole insurance" rates (yes, that term applies to life insurance, but is an apt comparison in terms of pricing) for what is essentially "term insurance" (which, in the life insurance segment, is quite a bit less expensive, because after the term, you're uninsured).
2. I tried to do eveything "right". Carried insurance when I could, when I was younger. Carried it with the best company and policy I could get. Didn't resent that I was paying it much more than I was getting out: It's "insurance", and if I'm healthy, I've already "won". I'm glad the money can go to those who need it (patients, I was assuming).
Despite doing everything "right", my last corporate job got off-shored. At a time when the individual insurance market was going from ridiculous to impossible. I managed to hold onto some form of insurance by dint of personal connections, to watch exclusions slapped onto my individual policy (for things the doctor had said he wouldn't treat -- too minor, risk/benefit not worth it -- while I was still on the corporate group policy). To watch my premium rates triple in three years.
The ACA came along just in time to rescue me from the looming vast pool of the uninsured. Which, once you entered, you had a very hard time exiting.
I never received a subsidy from the ACA. It simply allowed me to participate.
And by the way, the biggest injury to it? It was written to make insurers whole for their losses, until they had a handle on their demographics. Well, under Congress, funding is always a separate exercise -- the budget process -- from the laws and activities that that funding in turn enables.
And the Republicans simply refused to produce the funding mandated in the ACA. The numbers I heard from and expert in the field is that insurers were getting about 17 cents on the dollar for losses the ACA law told them would be reimbursed.
In other word, it wasn't simply imperfect and in need of improvement. A starting point, per those who negotiated and accepted some pretty terrible compromises in order to get it passed and some improvement in coverage started.
It was actively sabotaged.
Ok, I find I have a third point to make right now:
3. When the ACA was proposed, I believe it was not at all a "left" initiative. It was meant to be pretty middle of the road.
Around that time, 2007-8, and for some years prior, businesses were crying bloody murder at the year over year increases in health care costs they were facing. Often well into the double digits, year after year.
And they were saying, 'We can't compete with foreign competition from societies that have universal health care, where their costs are perhaps half ours and are increasing at single digit percentage rates.'
The ACA was meant to address "conservative" business problems as much as "social" individual and community problems.
All that was sabotaged, dealt with in bad faith, for the sake of the political and power agendas of the selfish.
By the way, the ACA has produced substantial improvements on the group insurance side of things. For individuals, and for businesses, by holding cost increases down.
And insurers have made good profits on these changes and their group policy business. Money they don't include in their accounting when they turn around and describe all the losses they've faced under the ACA marketplace plans (which are classified as "individual" insurance plans, not part of the traditional group policies/business).