So, now that a few months have passed and the Affordable Care Act hasn’t spawned “Government Death Panels” (or whatever the hell paranoiacs were screaming about a few years back), I notice the political fallout over Obamacare has gotten pretty quiet. The results are, basically, what the sanest commentators said all along— a lot of people who couldn’t afford insurance now have policies, some people were well served and got good deals, and other people got screwed into buying lousy policies (or will be penalized at tax time next year for refusing to buy any policy at all).
Also: no one can buy new health insurance coverage until a new sign-up period next November, which is quite shitty and which was NOT initially reported in the press. Technically one could buy insurance outside of the prescribed enrollment period— just not necessarily “qualifying policies.” Meaning companies might still sell you insurance policies that don’t cover everything the ACA legally requires them to cover— policies not good enough to evade the non-coverage penalty. But they won’t.
I have some friends who are deliriously happy with their new policies, and some who aren’t. The cheapest policies available on the Government Exchanges seriously suck… but that’s why they are the cheapest option. There’s little difference between those cheap plans and the lowest level Medical Insurance people could buy BEFORE the ACA took effect (except they may get wider coverage with the post-ACA version).
If you refuse to buy anything at all, you’re subject to a “fine” equal to 1% of your yearly household income (based only on income earned ABOVE the tax filing threshold). The fine goes up to 2% in 2015 and 2.5% in 2016. The SCOTUS ruled it a legal “tax” on people who don’t buy health insurance, to help allay the medical costs when the uninsured wind up requiring medical care (as demanded by law) in some E.R. But since there’s no provision for the government to penalize those who are fined (or even to COLLECT the fine itself), all the government can do is deduct it from any tax return you may be owed, next April 15.
See, here’s the thing: Health Care is either “free” (provided by the government to its citizens), or else it’s not. If it is, then essentially everybody gets free Medicare (and pays an extra tax to cover it), and that’s that.
But If that happens the insurance companies lose trillions of dollars, and medical costs can no longer be mercilessly inflated at the expense of those big insurance companies, so the medical industries— pharmaceutical, diagnostic, and physician/providers—have to drop their prices. And lower prices mean the medical industry is a less profitable business, meaning the quality of care will drop. Less money in any industry usually means a loss of service quality.
There are lots of extremely high-paid people in those industries who don’t want that to happen. So the ACA got drafted into law (and it’s really a LOT more than just an insurance mandate— it’s a massive batch of regulatory laws that try—clumsily—to reform the health care industry without pissing off the big money behind various government factions, i.e the multi-trillion dollar insurance industry). The ACA kind of works (yay). It also kind of sucks (boo). Much depends on your specific situation.
The ACA intends to create a system that works WITH the insurance companies to help regulate and reform that industry by signing everyone up for SOMETHING, and forcing those companies to stop rotten practices like canceling people’s coverage when they get sick, or selling people crap policies that never pay on anything. But the low end policies— like the cheapest “bronze” plans on the government exchanges— are always going to be shitty because they are so cheap (relatively) per month.
We could all have “free” Health Care where everyone pays an extra hundred bucks a month in taxes and the government subsidizes the rest. We already pay for Medicare from every paycheck, even if we don’t qualify for it ourselves. That’s called a “single-payer” system. Which has been branded as “Satan-spawned Socialism” by those who oppose it— most of whom are funded by— you guessed it— THE INSURANCE INDUSTRY.
But that’s NOT what we have. The way it’s set up under the ACA, people either get insurance or pay an extra tax (per person) instead. However, most insurance you buy now has better long-term options and provisions, and offers more patient protection, than ever before.
So that’s where things stand. And business is booming for the insurance companies… naturally.