5 ms·

The ACA ossified the existing system a bit, but employer-provided care was the norm before the ACA. That or just not having any insurance, especially for young

The ACA ossified the existing system a bit, but employer-provided care was the norm before the ACA. That or just not having any insurance, especially for young people working for small companies.

lotsofpulp 4y ago
ACA did not ossify it. If anything, ACA allowed non employers to purchase insurance. Previously, the options were to work for a deep pocketed employer or just not have insurance.
- ghaff 4y ago
  Plans that would cover pre-existing conditions was one very important change for a lot of people. What ACA didn't really solve was the "affordable" part for people who aren't fairly high income. Between the marketplaces in most states and COBRA for those in between jobs or near 65, insurance is available but it's expensive with no one else chipping in a big chunk of the premium.
  - lotsofpulp 4y ago
    Nothing will solve the affordable part other than massive wealth transfers (which ACA did, but obviously not massive enough), and increased supply of healthcare (more docs, hospitals, medication manufacturers - or medicines in public domain), and tort reform. But ACA did what it could with the political compromises that had to be made at the time. It provided out of pocket maximums, maximum age rating factor (age 64 only pays 3x age 21), and required coverage for all applicants (removing risk of disqualification from pre existing condition). It is unfortunate the mandate was repealed and state level participation in functioning marketplaces was politically hampered.
    - ghaff 4y ago
      Yeah, even if you just arbitrarily chop 20-30% off of US healthcare costs--which aren't just from the pockets of fairly low margin insurance companies, the money still needs to come from somewhere. So maybe a random individual can get a decent insurance plan for $5K/year with a family plan something north of $10K without a company paying. I expect a lot of people would still not find that reasonable and would want someone else to pay for it.

The ACA ossified the existing system a bit, but employer-provided care was the norm before the ACA. That or just not having any insurance, especially for young people working for small companies.

lotsofpulp 4y ago

ACA did not ossify it. If anything, ACA allowed non employers to purchase insurance. Previously, the options were to work for a deep pocketed employer or just not have insurance.

ghaff 4y ago
Plans that would cover pre-existing conditions was one very important change for a lot of people. What ACA didn't really solve was the "affordable" part for people who aren't fairly high income. Between the marketplaces in most states and COBRA for those in between jobs or near 65, insurance is available but it's expensive with no one else chipping in a big chunk of the premium.
- lotsofpulp 4y ago
  Nothing will solve the affordable part other than massive wealth transfers (which ACA did, but obviously not massive enough), and increased supply of healthcare (more docs, hospitals, medication manufacturers - or medicines in public domain), and tort reform. But ACA did what it could with the political compromises that had to be made at the time. It provided out of pocket maximums, maximum age rating factor (age 64 only pays 3x age 21), and required coverage for all applicants (removing risk of disqualification from pre existing condition). It is unfortunate the mandate was repealed and state level participation in functioning marketplaces was politically hampered.
  - ghaff 4y ago
    Yeah, even if you just arbitrarily chop 20-30% off of US healthcare costs--which aren't just from the pockets of fairly low margin insurance companies, the money still needs to come from somewhere. So maybe a random individual can get a decent insurance plan for $5K/year with a family plan something north of $10K without a company paying. I expect a lot of people would still not find that reasonable and would want someone else to pay for it.