The Affordable Care Act: Who Was Helped Most

Before if you had minor medical stuff insurance was there. But as soon as you got legitimately sick (e.g. cancer) they quite literally went back through every form you ever filled out looking for an error, typo, or omission in order to cut you.

Worse still they actually designed forms to increase the chance of error for exactly this reason. Did you ever wonder why you have to sign it three different times on different pages? That is why.

Plus if you got laid off previously you were in deep trouble since your new employer's insurance company would reject you and you'd struggle to work while sick regardless.

Honestly Obamacare improved things decently. Only short-sighted greedy people are unhappy. Next challenge: Unlink health insurance completely from employment.

Health insurance from your employer is bad for everyone. It reduces consumer choice (e.g. you have the "choice" to either go with the company your employer picked or nothing), and it makes SMBs much less competitive than large corporation.

Startups in particular struggle to offer employees health insurance even if they can afford to offer a competitive income (as they pay disproportionately more for health insurance than a much larger company).

At least an argument can be made for why the "public option" (nationalised health care) is a bad idea, I've heard no good arguments for why unliking employment from health care is. Except "I get really good healthcare right now and I am too lazy to shop around for it."

The only organisation that should be allowed to offer their own health insurance/care is the US military, and that is more for practical reason.

Young male entrepreneurs didn't run into this problem because they were male, which conveniently dodges more than half of the "DO NOT COVER" list, and because they usually don't yet have families. But cross 30, get married, have a kid, time travel back to 2007 and try to insure your family. You'll see, like I did, how helpful the ACA is for startup founders.

http://www.huffingtonpost.com/2014/04/10/obamacare-patients-...

Yup. The most obvious problem is that when you change jobs, you change providers. That alone is undesirable and contributed to the problem of rejections due to pre-existing conditions.

The less talked about aspect is that large companies are self insured. Meaning they cover all the costs and just have an outside company manage the plan. The issue with self insured companies is that on average, working folks are healthier than non-working ones. That means it shifts the higher costs to the non-corporate plans - medicare/medicaid.

Just taking away the incentives for this and having people get their own plan would have gone some way toward a better system.

>in terms of number of doctors

what does that even mean?

I mean, it sounds like you're just pointing out that, if health insurance/coverage is mandatory, then you are getting 'screwed' if you don't use the healthcare system. That's like saying I'm getting 'screwed' by public transportation if I own a car.

Another way to think about it is that you're paying $120/mo for the guarantee that you'll be able to obtain coverage for your spouse and children in the future. That guarantee did not exist at any price prior to ACA.

I'm not sure how to respond to your last point, because people who don't work have always received health care for free. The backstop for health care financing has never been "no health care". The backstop is bankruptcy, which isn't an issue for the unemployed poor.

By extending health care to people who can't afford it, the ACA has probably lowered your costs over the long term. That's because the most expensive possible way to provide coverage is through emergency room visits, which is how the uninsured obtain coverage.

  ...people who don't work are getting health care for free.

From the article:

  Critics of the Affordable Care Act have
  often warned that the program would be unfair
  to the young because it limits the ability of
  insurance companies to charge higher rates to
  older customers, who tend to be sicker. But
  young adults show the largest reductions in
  being uninsured of any age group.

Not only was I employed full time, I was restarting school. I lost everything. Tuition I paid, loan privileges, I had to sell everything, my credit sucks. Until the ACA went into affect I avoided doctors, even for big stuff because I was terrified of getting my family dropped.

I can go to the doctor and many people I know from cancer support groups can get insurance now, I'm not just talking about those who don't work, it was really hard to just get a company that would cover you when you've had cancer multiple times.

I know it sucks for some people but it's helping so many people who really needed the help.

- Your phrasing of "people who don't work" implies to me that you feel disdain towards them, and that they could work, but are just lazy. (and now they can "freeload" health care too!) If this is not the case, then I would change the phrasing to something like "people that are unemployed."

- "What's in it for me?" isn't always the best measure of the value of something. For example, Bill Gates can afford to pay all his health costs out-of-pocket. Would you agree with him if he said that we should dismantle the entire health insurance industry because he doesn't need it?

- You haven't explained what level of coverage you think that the "non-working" people had before. Do you think that their level of coverage has improved or declined?

> Now with Obamacare I am paying $260 for the same level of coverage. [...] How is that helpful to me?

Insurance companies now have to account for the risk that if you get sick in a chronic/expensive way that they can't find some technicality to drop you. Whether you see this as a benefit or not is probably correlated with your belief that those things "happen to other people."

Some people are getting subsidized care but the only people getting it for free are those who are eligible to enroll in Medicaid. Not all states have agreed to increase their Medicaid rolls however. Plus, as a Medicaid patient, it is not that easy to find doctors, especially specialists, who are willing to see you. I had a Medicaid patient who had surgery for a wrist fracture a few weeks ago. The orthopedist who operated on her would only agree to see her in follow up in a separate clinic for 'caid patients, and that appointment would be in February. Fortunately we were able to encourage the surgeon to see them sooner. Im guessing that's not the kind of healthcare you want, even if it's free.

I am a bit bothered that the NYTimes chose to ignore a wealth of data for a major current societal problem, and just cherry-pick some category that ended up "better" to make a map and article.

Violence Against Women Reauthorization Act of 2013

It turns out this law doesn't authorize or reauthorize ANY violence against women. It seems to do the exact opposite of what it says -- it is primarily about _punishing_ violence against women.

That is all, continue being outraged. I'm sorry your insurance costs more, that does suck.

Really? Reporters and politicians have searched for these mysterious slighted people who have had their premiums go up for the exact same plan. You should call the O'Reilley factor, you could be a star!

A lot of people could not buy crippled insurance plans with insanely high deductibles and severe limits on coverage, because those were outlawed by the plan. Also, some people were bumped from subsidized plans to fend on the open market, but that's shitty employers taking advantage of their employees, and not the fault of the ACA.

Finally, with the heavy subsidies to your premiums, the same plan usually cost less under the ACA. You could however talk about the cost of insurance in 5 years when the subsidies start to wear off, but, hey, I imagine the republican leadership has plenty of ideas to help the common folk with that.

I don't think it was meant to reduce the cost of insuring someone but to reduce the rate of the increases. Remember how fast health insurance premiums were going up in the late Bush and early Obama years?

To answer the headline of the article I did not read... The health insurance companies?

It's not rational for anyone to be uninsured. Any healthy person could get in an accident.

Health spending was growing at an average of 7.2% / year from 1990-2008, vs an estimated 3.6% in 2013. Certainly the slowdown is the result of more than just the ACA, but this is the relevant metric one should use when measuring its success at cost containment, not the fact that almost everything gets more expensive from one year to the next.

http://content.healthaffairs.org/content/early/2014/08/27/hl...

(The $20,000 figure comes from my friend, whose teenager had appendicitis a couple years back).