5 ms·

The affordable care act doubled most people's insurance over night (This happened to me and almost everyone I know). Nobody wants to mention this, because it ma

by billy99k 10mo ago

The affordable care act doubled most people's insurance over night (This happened to me and almost everyone I know). Nobody wants to mention this, because it makes their side look bad. Until we can admit where there are problems, there will never be a solution.

slackfan 10mo ago
Nearly tripled in my case, but I've literally been either told that that was a conspiracy theory (still flabbergasted as to how?), or been argued against with some vague appeal-to-emotions with regards to "but the poor people without health coverage". I wasn't exactly just out of minimum wage territory living paycheck to paycheck as a junior sysadmin at the time either, but who's counting, right?
- dominotw 10mo ago
  ok its appeal to emotion but why is it vague?
  - slackfan 10mo ago
    Because at the time I could name about 20 people who lived at or below minimum wage with or without healthcare insurance and the ones that would conduct this appeal could not.
ChrisRR 10mo ago
As a non-american this is the first I'm hearing of this. I would've thought if the majority of americans' health insurance had double overnight then there would've been massive uproar. Can you explain what's happened?
- slackfan 10mo ago
  The health insurance companies were given massive government subsidies to insure the previously (theoretically) uninsurable with no real provisions to cap rate hikes for anybody, and no alternative plan (public alternative that was originally part of the bill was killed). Large corporations received a captive market where people HAD to purchase health insurance (or pay a relatively onerous-at-the-time fine). Insurance companies wrote for, edited, and lobbied around most of the bill as it was passed. E: A fun downstream effect of it was that employer-provided insurance rates also went through the roof.
- triceratops 10mo ago
  He's exaggerating. It wasn't literally overnight but over several years.
  - AlotOfReading 10mo ago
    The ACA was intended to reduce the rate of rate increases, not reduce the cost overall. The proper comparison is to what the rates would have been without the ACA. As usual, actual studies are all over the map on this. The white house said it was successful at that. NBER said it wasn't, but rates didn't double for a long time. We know rates of large increases went down for a few years, but small increases became nearly universal to compensate.
- nicole_express 10mo ago
  I wonder if this is a regional issue; didn't do anything of the sort for me and people I know in Massachusetts, but there the Affordable Care Act wasn't that different than the existing "Romneycare" state regulation. In cases where state regulation was much lesser I guess it likely had a bigger impact.
- deleted 10mo ago
  [deleted]
jmathai 10mo ago
The two times I did not have employer sponsored health care AND $0 income, the ACA plans were more expensive than getting a plan directly from the insurance company. It never costed me $27,000 though. Most recently, in 2024, I had medical and dental coverage for my family of 6 for around $1,200/mo - roughly half what's quoted but again, family of 6. Wasn't the greatest insurance but it would have kept us from financial ruin in case of a catastrophic event which is all I expect from insurance anyways.
- brianwawok 10mo ago
  I assume you were young. Direct was generally cheaper for young people and ACA cheaper for older people. Which pushed the average age of ACA up and then raises the price of ACA. It’s a mess!
  - jmathai 10mo ago
    45 years young.
silverquiet 10mo ago
I gained insurance overnight because of the ACA after not being able to afford it.
jqpabc123 10mo ago
The fundamental problem is the very idea of private "health insurance". Market forces naturally create low rates for those who don't need insurance and unaffordable rates for those who do. But over time, everyone gravitates from the former to the latter. The "free market" does not offer a practical solution to every problem. Tariffs are an open admission of this basic fact.
- aleph_minus_one 10mo ago
  The problem rather is the insane amount of red tape involved if you want to set up your own health insurance company. Thus hardly any competition for the established player arises. The result is what any arbitrary textbook about economy will tell you: if there are large barriers to entry into a market (i.e. the opposite of "free market"), the customer won't get the positive consequences of a free market, but instead oligopolies will form - with their negative consequences.
  - AlotOfReading 10mo ago
    There's around a thousand organizations in the US that have gone through the paperwork to set up as a health insurance company and continue to file paperwork to that effect.
  - jqpabc123 10mo ago
    There are lots of health insurance companies operating in the USA. United Health is the largest but they only have a 15% market share. All these companies follow suit with the market forces described above. They all want to insure young healthy people and deny old sick people --- simply because they make more money by doing so. Over time, everyone (including you) will naturally gravitate from young and healthy to old and sick --- aka uninsurable. Are you content for yourself or your family to be uninsured when they need it most --- after a lifetime of paying premiums? This is what private, for-profit health insurance manifests. This is not due to "red tape" or lack of competition but is a fundamental and unavoidable characteristic of the "free market" itself.
    - 10mo ago
jdlshore 10mo ago
That doesn’t pass the sniff test. I was self-employed and self-insured when the ACA took effect and my premiums immediately dropped when I purchased through the Marketplace (and it wasn’t subsidized). It sounds like you either had junk insurance or you’re exaggerating things to score points.
- antonymoose 10mo ago
  When the ACA plans first came online in South Carolina, I switched over immediately. I was paying something like $300 per month as a young healthy single male with my small company plan. I got a Marketplace plan for about $120 per month. The next year my insurer went out of business but I found another insurer in the 200s, barely cheaper. The following year this insurer also went under. I was now left with Blue Cross as my only real option charging I believe $350 per month and this continued to rise year on year, very painful for me when I was launching a startup with a minimal salary draw. Maybe your state is different but for me it killed numerous companies and left me with expensive, low quality options.
  - jdlshore 10mo ago
    Yes, health insurance costs rise every year. Partly due to increasing costs, but also due to the age of the insured. The question isn’t whether the ACA raised costs—those were always going to go up. The question is whether a the ACA made them go up less than not having it. For me, the before and after trend was remarkable. And I had higher quality insurance without lifetime maximums or arbitrary exclusions. Republicans did their level best to neuter the bill and prevent Democrats from having a “win,” and for the most part, I’d say they succeeded. The lack of a public option and the removal of mandatory coverage were both important parts of making it work well. But in the first 5 years or so, it was definitely an improvement. I think it could be again… if Republicans cared more about serving the country than pandering to their base.
    - xhkkffbf 10mo ago
      > those were always going to go up No. That wasn't the promise. Obama said that his plan was going to cut a family's bills by $2500. Now you may say that inflation has to creep in and I think that's fair. If oil rises in price, that affects everything. But the premise was always that the magic of the ACA would lower premiums.
brianwawok 10mo ago
Did not change my rates a bit. And it gave me a fallback plan if I lost my job or something.
trashface 10mo ago
I can only speak for myself and not "most people" but before the ACA I was actually denied for health insurance - as in, insurers would not sell me insurance at ANY price. After ACA went into effect, I got insurance and it was reasonable - I didn't even need to claim a subsidy for first few years, until I lost my job.

slackfan 10mo ago

Nearly tripled in my case, but I've literally been either told that that was a conspiracy theory (still flabbergasted as to how?), or been argued against with some vague appeal-to-emotions with regards to "but the poor people without health coverage". I wasn't exactly just out of minimum wage territory living paycheck to paycheck as a junior sysadmin at the time either, but who's counting, right?

dominotw 10mo ago
ok its appeal to emotion but why is it vague?
- slackfan 10mo ago
  Because at the time I could name about 20 people who lived at or below minimum wage with or without healthcare insurance and the ones that would conduct this appeal could not.

ChrisRR 10mo ago

As a non-american this is the first I'm hearing of this. I would've thought if the majority of americans' health insurance had double overnight then there would've been massive uproar. Can you explain what's happened?

slackfan 10mo ago
The health insurance companies were given massive government subsidies to insure the previously (theoretically) uninsurable with no real provisions to cap rate hikes for anybody, and no alternative plan (public alternative that was originally part of the bill was killed). Large corporations received a captive market where people HAD to purchase health insurance (or pay a relatively onerous-at-the-time fine). Insurance companies wrote for, edited, and lobbied around most of the bill as it was passed. E: A fun downstream effect of it was that employer-provided insurance rates also went through the roof.
triceratops 10mo ago
He's exaggerating. It wasn't literally overnight but over several years.
- AlotOfReading 10mo ago
  The ACA was intended to reduce the rate of rate increases, not reduce the cost overall. The proper comparison is to what the rates would have been without the ACA. As usual, actual studies are all over the map on this. The white house said it was successful at that. NBER said it wasn't, but rates didn't double for a long time. We know rates of large increases went down for a few years, but small increases became nearly universal to compensate.
nicole_express 10mo ago
I wonder if this is a regional issue; didn't do anything of the sort for me and people I know in Massachusetts, but there the Affordable Care Act wasn't that different than the existing "Romneycare" state regulation. In cases where state regulation was much lesser I guess it likely had a bigger impact.
deleted 10mo ago
[deleted]

jmathai 10mo ago

The two times I did not have employer sponsored health care AND $0 income, the ACA plans were more expensive than getting a plan directly from the insurance company. It never costed me $27,000 though. Most recently, in 2024, I had medical and dental coverage for my family of 6 for around $1,200/mo - roughly half what's quoted but again, family of 6. Wasn't the greatest insurance but it would have kept us from financial ruin in case of a catastrophic event which is all I expect from insurance anyways.

brianwawok 10mo ago
I assume you were young. Direct was generally cheaper for young people and ACA cheaper for older people. Which pushed the average age of ACA up and then raises the price of ACA. It’s a mess!
- jmathai 10mo ago
  45 years young.

silverquiet 10mo ago

I gained insurance overnight because of the ACA after not being able to afford it.

jqpabc123 10mo ago

The fundamental problem is the very idea of private "health insurance". Market forces naturally create low rates for those who don't need insurance and unaffordable rates for those who do. But over time, everyone gravitates from the former to the latter. The "free market" does not offer a practical solution to every problem. Tariffs are an open admission of this basic fact.

aleph_minus_one 10mo ago
The problem rather is the insane amount of red tape involved if you want to set up your own health insurance company. Thus hardly any competition for the established player arises. The result is what any arbitrary textbook about economy will tell you: if there are large barriers to entry into a market (i.e. the opposite of "free market"), the customer won't get the positive consequences of a free market, but instead oligopolies will form - with their negative consequences.
- AlotOfReading 10mo ago
  There's around a thousand organizations in the US that have gone through the paperwork to set up as a health insurance company and continue to file paperwork to that effect.
- jqpabc123 10mo ago
  There are lots of health insurance companies operating in the USA. United Health is the largest but they only have a 15% market share. All these companies follow suit with the market forces described above. They all want to insure young healthy people and deny old sick people --- simply because they make more money by doing so. Over time, everyone (including you) will naturally gravitate from young and healthy to old and sick --- aka uninsurable. Are you content for yourself or your family to be uninsured when they need it most --- after a lifetime of paying premiums? This is what private, for-profit health insurance manifests. This is not due to "red tape" or lack of competition but is a fundamental and unavoidable characteristic of the "free market" itself.
  - 10mo ago

jdlshore 10mo ago

That doesn’t pass the sniff test. I was self-employed and self-insured when the ACA took effect and my premiums immediately dropped when I purchased through the Marketplace (and it wasn’t subsidized). It sounds like you either had junk insurance or you’re exaggerating things to score points.

antonymoose 10mo ago
When the ACA plans first came online in South Carolina, I switched over immediately. I was paying something like $300 per month as a young healthy single male with my small company plan. I got a Marketplace plan for about $120 per month. The next year my insurer went out of business but I found another insurer in the 200s, barely cheaper. The following year this insurer also went under. I was now left with Blue Cross as my only real option charging I believe $350 per month and this continued to rise year on year, very painful for me when I was launching a startup with a minimal salary draw. Maybe your state is different but for me it killed numerous companies and left me with expensive, low quality options.
- jdlshore 10mo ago
  Yes, health insurance costs rise every year. Partly due to increasing costs, but also due to the age of the insured. The question isn’t whether the ACA raised costs—those were always going to go up. The question is whether a the ACA made them go up less than not having it. For me, the before and after trend was remarkable. And I had higher quality insurance without lifetime maximums or arbitrary exclusions. Republicans did their level best to neuter the bill and prevent Democrats from having a “win,” and for the most part, I’d say they succeeded. The lack of a public option and the removal of mandatory coverage were both important parts of making it work well. But in the first 5 years or so, it was definitely an improvement. I think it could be again… if Republicans cared more about serving the country than pandering to their base.
  - xhkkffbf 10mo ago
    > those were always going to go up No. That wasn't the promise. Obama said that his plan was going to cut a family's bills by $2500. Now you may say that inflation has to creep in and I think that's fair. If oil rises in price, that affects everything. But the premise was always that the magic of the ACA would lower premiums.

brianwawok 10mo ago

Did not change my rates a bit. And it gave me a fallback plan if I lost my job or something.

trashface 10mo ago

I can only speak for myself and not "most people" but before the ACA I was actually denied for health insurance - as in, insurers would not sell me insurance at ANY price. After ACA went into effect, I got insurance and it was reasonable - I didn't even need to claim a subsidy for first few years, until I lost my job.