How much of this is “Obamacare changed my insurance for the worse” and how much is “my employer took advantage of this opportunity to decrease how much insurance they had to pay for”?
In my case, for example, the latter had a much bigger effect than the former. For example, they made it a selling point that they paid 100% of the premiums for single coverage, but they declined to increase the amount they paid for that coverage. Even with the relatively modest medical cost inflation of the last few years, to achieve a flat premium something else had to give, and for my employer then, it was deductibles and co-pays.
(That is: if a certain policy with a given deductible/co-pay combination costs $500/mo. per employee in Year 1, with even 5% medical inflation by Year 3 that same coverage will cost $551.25. If the employer is only willing to continue to chip in $500, and employees don’t contribute anything, then you can’t have the same coverage–you can have either less coverage or higher deductibles/co-pay or some combination thereof. Alternatively, you can ask employees to pay premiums too, or at least add that into the mix. In any event, at the most basic level, I’m paying more because my employer is paying less, at least as a percentage of what it costs.)
Covered to what point? In Spain you have some time you can take to care for a loved one, but there’s a limit beyond which you have to go on unpaid leave. There are insurance schemes that will cover such leaves, but they’re not part of the national system. And some employers abuse the limits: there’s currently one of those “please sign” petitions regarding companies that declare medical leave to be tested for living organ donation as “inappropriate” and fire people or put them on probation for doing it (SS regs use “voluntary” as shorthand for “not covered”; living donation is covered but those companies are contending it’s voluntary).
Things like getting a caretaker or paying for home care, again there are aid schemes in place, but they can take a while to kick in. For my brother’s FiL, it was a matter of weeks; for my grandmother, a couple of years (differences in which regional government was involved, the level of honesty of the people filing for aid, and the same people’s timeliness).