I will preface this by saying that I am for the most part glad that the ACA was passed; I know that it’s helped a lot of people. I would prefer something much closer to a British style NHS, but I suspect that may not ever be achievable in my lifetime.
Obamacare had no noticeable effect on me personally. I get my health insurance through my employer, then as now, and it’s pretty good. Very little changed about it.
For my younger brother, however: the most immediate effect of the ACA on him was that his hours at work were cut, and they did not come back. ACA mandates that large employers must offer health insurance to their full-time employees, with 30 hours per week being considered full-time. Before the passage of ACA, my brother was usually getting 30-35 hours every week. When the employer mandate took effect, his company (a grocery store chain) decided that, rather than offer health insurance, they would just cut everyone’s hours so that they had no “full-time” employees. Net effect on him: he was bringing home less money every week, and he was required to buy insurance on the Exchange. Even the bronze-level plans that he could find had higher premiums than he could easily afford.
I know a lot of people in similar positions, whose premiums went up under the ACA, sometimes to the point of causing genuine financial hardship. As I said, I’m generally in favor of what the legislation is trying to accomplish. But the effect on a lot of people has been negative, and I’m honestly not surprised that many people hate it.
My income falls in the Medicaid-expansion band, so the ACA definitely helped me. Though I’m also healthy enough that I haven’t used my Medicaid for anything other than a routine check-up and some flu shots, so it (or any other sort of health insurance) hasn’t had the chance to really help me all that much.
Yes it has helped us tremendously! We’re self insured and gainfully employed. Michigan expanded medicaid under the ACA and we signed up the first year.
Premiums have gone up due to us losing dependents ageing out, making more $ but the premiums are nowhere near what they were before ACA. coverage for pre existing conditions is a blessing. Before we were penalized and forced into a multi year contract before it was covered.
I love that I have insurance no matter what, I can change jobs without worrying about losing the insurance plan that I chose.
Sure there’s a high deductible I’ll never meet. But it doesn’t really matter at this point, though one day it will matter I suppose.
I don’t like paying premiums and paying a negotiated rate for a specialist office visit like physical therapy. Guess I should be glad it’s $98 a visit and not the $598 that is billed to insurance.
Free vaccines, free yearly mammograms and free annual physicals are welcome and I utilize those services. They added a vision plan this year but it’ll be gone next year. Use it or lose it.
I had to visit the Dr, she’s part of a hospital system’s integrated care campus, to check out my knee and ankle from a bruising painful fall. They took x-rays, I also got vaccinated while I was there, my bill was $30 copay. Though I haven’t seen a radiology bill yet, nor an eob for radiology. I wonder if I’ll get one. I believe I should but maybe not?
Disclaimer: I work in advertising, and my main client is a major regional insurance company, so I follow the topic quite a lot.
And, yes, from what I’ve seen, more broadly, the responses we’ve seen in this thread are pretty indicative of the effects we’ve seen.
If you work full-time, and get your health insurance from your employer, you may have seen little or nothing in the way of effect from the ACA. Your premiums may have gone up, or your deductible may have gone up, but the amount that employees have been expected to pay has been steadily increasing anyway, ACA or no.
However, if your old employer-offered plan was made illegal by the ACA (that is, it wasn’t a comprehensive plan), you may have wound up having to pay more for health insurance, or (if you were part-time, or work at a small company) your employer may not be offering you health insurance at all anymore. Granted, a lot of those “non-compliant” policies weren’t great (often, they were inexpensive because they didn’t cover a lot), but it’s undeniable that some people who had them liked them just fine, typically because they were not heavy users of healthcare.
Similarly, if you were able to buy an inexpensive individual policy before the ACA, many of those policies went away, as they weren’t compliant with the ACA. You can still buy an individual policy, but it’s likely significantly more expensive, and you can’t, generally, “opt out” of some of the benefits of ACA policies (screenings, reproductive health, etc.) in order to reduce your premium.
As @MrAtoz notes, there are also some people who saw their work hours cut from full time to part time, so that their employer no longer was required to offer them health insurance.
If you weren’t able to buy an individual policy before the ACA (e.g., due to a pre-existing condition), you’re now able to do so. However, ACA policies are often pretty expensive, and unless you qualify for a subsidy, you’re paying a lot out-of-pocket for your coverage; however, as many of these people do have significant healthcare expenses, an ACA policy may still be worth it for them.
In some states, the ACA led to an expansion of Medicaid, letting some people who made too much to qualify for Medicaid before, now get Medicaid coverage.
However, in states that refused to do the Medicaid expansion, there are many people in the “Medicaid Gap,” who make too much to qualify for Medicaid, but don’t make enough to qualify for a subsidy to pay for an ACA policy, and so, they’ve likely remained uninsured.
Most people in group 1 saw little or no net effect. People in groups 2, 3, and 4 were very likely better off before the ACA. Groups 5 and 6 are definitely better off now, and group 7 was left behind by the entire thing – they weren’t covered before, and they still aren’t.
Yes. It’s why my parents still have medical insurance despite my mom being retired due to illness and my dad being unemployed.
The idea that Obamacare is bad in the middle of a pandemic where the extended Medicaid is needed more than ever is utter ridiculousness. I question if the rank and file republicans are even against it anymore–only at most hating the nickname.
Still have our Obamaphone, too, BTW. I’ve always wondered why that hasn’t been targeted to dismantle due to its nickname.
I think yours is a fairly straightforward representation of where the unfinished ACA left us just after it was enacted. Obama always characterized what he was able to accomplish with an obstinate Republican party as half a loaf.
However, I would pick the nit that it was never possible, so far as I understand, to opt out of benefits in order to reduce premiums. It’s kind of a right-wing talking point to imply it was otherwise at some point. Am I wrong about that?
The ACA didn’t affect me directly as far as I can tell. I was a unionized government employee, so I already had a good health insurance plan and I’ve kept it in my retirement.
A public health care system is a good idea and I strongly support having one. But it’s not an issue that affects me personally.
AFAIK, that’s correct. What people who weren’t happy with losing their old, non-compliant plans are angry about is that they are now having to pay more, for aspects of their coverage that they don’t want and don’t feel that they need, and it’s very difficult, if not impossible, to buy a “bare bones,” or catastrophic-only, policy now.
Note: some insurance companies offer “short-term” health insurance policies, which don’t have to be ACA-compliant (they essentially exploit a loophole in the ACA), and which are generally relatively inexpensive, “basic” coverage. However, insurers can elect to not sell you a short-term policy if you have a pre-existing condition (so, it’s much like the pre-ACA individual policies), and you can’t carry a short-term policy indefinitely.
I have no quarrel with this statement. At the time Obama made his pronouncement about “if you like your doctor, you can keep your doctor,” he was not aware of how substandard many of the plans were. When he required employers to upgrade coverage to Minimum Essential Coverage (MEC) plans, insurance companies responded by offering much more expensive plans with limited networks.
I’ve long said the problem with health care in this country isn’t access to coverage. It’s access to health care. The insurance companies want to make sure we can only have access through them. That’s the problem.
Sorry, as I know this stance affects your employment. But if we ever manage to achieve a single payer health care system, it will put me out of business, too. (I’m cool with it.)
Oh, yes. This was one of the first things the Trump “administration” did to roll back Obamacare coverage. It was the exact vise I was caught in before Obamacare was enacted. Obamacare has already been badly damaged by Trump throughout his so-called presidency, even if it is not fully overturned by SCOTUS.
I’ve worked on many other clients, in many other industries, and even if I’ve somehow managed to become one of our agency’s primary SMEs (Subject Matter Experts) on health insurance, I can always find work on other accounts or other agencies.
Canadians love Obama. Trump is mainly popular with a fraction of Conservatives - at most 10-15% of Canucks. As a result, Obamacare is assumed here to better than it is, even if one believes compromises were unavoidable.
The Dopers have educated me about their experiences. Thank you. The last question I asked has been answered less often. Let me modify it in an optimistic and practical way. What feasible steps do you think should be taken next if the Democrats win the House and Senate, if any?
Take the high ground, and offer to work for meaningful compromise bi-partisan legislation. Ask for the Republicans’ help. Ask, even beg, that they return to being contributing partners in the process. Offer them stuff they want.
Now, we all know what will happen… But this is the first thing that needs to be tried.
The public option is the most important thing that needs to be implemented. The biggest thing that separates the US from countries that have effective universal healthcare systems is that we don’t have a public healthcare payer available to everyone (whether a single-payer or a mixed public/private system).
The next step would hopefully be to nuke the filibuster and pass a bill that includes the public option. Personally I would give up every other element of Biden’s healthcare plan just to get that.
It’s also pretty important to reintroduce a healthcare mandate - I have to think the current system is unsustainable long-term. However if Biden’s public option plan is applied to the letter this wouldn’t be necessary because people would be automatically enrolled in the public option if they lose healthcare.
You may well be right, and don’t get me started on what I think about Joe Lieberman. However, I recall an extremely lengthy process where Obama tried again and again to garner Republican buy-in to the legislation, forced to give up more and more. Ironic, since (as I’m sure you know) it was based entirely on Romney’s plan for Massachusetts.
I agree with every word of your post, but I’ll quote the last bit for a particular response. Unfortunately, SCOTUS already drove a stake through the heart of the healthcare mandate, declaring it unconstitutional to force people to participate in such a plan. You can bet Republicans will drag it all right back to the SCOTUS for another ruling against the people’s best interests if Biden legislates anything that requires mandatory participation.
Hell, I won’t be surprised if going forward, they try to use that earlier ruling as a basis to chip away at Medicare, too.
Since I’ve always had health insurance provided by my employer since 2011, there was essentially no impact on me by Obamacare. But it didn’t really help either. When I went to an ER for hyponatraemia in 2014, I still got charged well over a thousand dollars.
This actually does worry me. I don’t think the Dems should take any risks on this. They obviously have better lawyers than I do, but if they have to make the public option entirely voluntary and introduce the tax separately that is a much better solution than getting the public option struck down in court. If it’s possible that there’s a way to write automatic enrollment so that there’s essentially zero risk that’d be great, but no reason to take a chance.
EDIT: If you want to go with the 7D chess move, maybe you implement the public option, get it struck down in court, and then use that to get the public so riled up about it that you can put in single payer.
I do think this is why Biden’s first move will be to reduce the Medicare buy-in age to 60. It won’t be mandatory, but it’s going to be a lot more attractive than other options available to the over-60 crowd (which includes me). Taking away Medicare will be a lot, lot harder for Republicans to accomplish.