# What is your ongoing opinion of the Affordable Care Act? (Title Edited) **URL:** \ **Category:** Politics & Elections\ **Created:** [January 17, 2013, 11:21pm UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561 "2013-01-17T23:21:39Z")\ **Posts on this page:** 20\ **Page:** 38
**Author:** ![alec6542](https://avatars.discourse-cdn.com/v4/letter/a/a8b319/32.png) [@alec6542](https://boards.straightdope.com/u/alec6542)\ **Post date:** [November 21, 2013, 7:56am UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/742 "2013-11-21T07:56:46Z")
I am seriously conflicted on this. No doubt Obamacare is a train wreck, but, due do one of the most egregious practices of the health insurance industry, Obamacare at present is the ONLY way I can get insurance. Here’s my story. I had cancer when I was 5 years old, 22 years ago. I underwent extensive surgery and chemotherapy and spent almost a year in the hospital. Thankfully the treatment was successful and I have been cancer free since then. Two years ago when I fell off my parents health plan I decided to apply for private, individually underwritten health insurance through a broker. I am in perfect health, don’t smoke, but got DENIED insurance because I admitted my medical past on my application. I was devastated, and even my agent couldn’t believe a healthy 26 year old male would be denied health insurance. I spent a lot of time investigating what could have been the issue, and it turns out, from googling underwriting guidelines of a dozen or so insurance companies, the type of cancer I had, Burkitt’s tumor, is on the automatic decline list, regardless of current health or how long ago you had it. Absolutely ridiculous!! This is the kind of practice that I was happy to learn Obamacare has essentially abolished, which I believe is good thing. BUT, this whole business of letting people with a pre-existing condition apply AFTER they get sick is something else completely, which apparently Obamacare also allows, is a serious flaw. If you can wait until you get sick to get covered, IMO that’s not “insurance”, that’s something else completely. That’s like waiting until after your house is on fire to buy homeowner’s insurance, and since Obamacare places these kind of policies in the same risk pool as everyone else, there’s no question premiums are going to skyrocket as a result. What’s really disappointing is that the whole thing could work if it wasn’t for politics . Political opposition will all but ensure it’s eventual failure and ultimate repeal, this I am sure of, and now I am worried that if when we go back to the status quo, I will lose any policy I get from the exchange and have no way of getting covered again. (btw I still haven’t got that policy yet because the website still doesn’t work) ---
**Author:** ![DonnieBarko](https://avatars.discourse-cdn.com/v4/letter/d/e19adc/32.png) [@DonnieBarko](https://boards.straightdope.com/u/DonnieBarko)\ **Post date:** [November 21, 2013, 6:35pm UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/743 "2013-11-21T18:35:46Z")
> [@](#): > > This is the kind of practice that I was happy to learn Obamacare has essentially abolished, which I believe is good thing. BUT, this whole business of letting people with a pre-existing condition apply AFTER they get sick is something else completely, which apparently Obamacare also allows, is a serious flaw. If you can wait until you get sick to get covered, IMO that’s not “insurance”, that’s something else completely. That’s like waiting until after your house is on fire to buy homeowner’s insurance, and since Obamacare places these kind of policies in the same risk pool as everyone else, there’s no question premiums are going to skyrocket as a result. This is why the individual mandate is critical to the success of the law. The fine for not having insurance during 2014 is relatively small: 1% of household taxable income OR $95.00 per adult and $47.50 per child (whichever is higher), but with a maximum tax penalty cap of $285.00. However, in 2015, that increases to 2% of taxable income OR $325.00 per adult and $162.50 per child (whichever is higher), capped at $975.00. In 2016, it increases to 2.5% of taxable income OR $695.00 per adult and $347.50 per child (whichever is higher), capped at $2,085.00. Beyond 2016, the penalty will be increased annually in proportion to cost-of-living increases. So could a younger, healthy person save money over the next few years by only obtaining insurance once they need it? Perhaps. For instance, a single person earning $50,000.00 would only have to pay a $285.00 penalty in 2014, a $975.00 penalty in 2015, and a $1,250.00 penalty in 2016. Such a person, if unmarried, would probably not be eligible for any federal subsidies on the exchange (for single persons, subsidies are limited to those earning less than four times federal poverty level), so they’d have to pay the full premiums. So, yeah, they would probably save money by not obtaining health insurance. And yes, if they needed long term treatment, such as cancer, they could just sign up for a platinum insurance plan after the diagnosis has already been made, and the bulk of their treatment going forward would be covered (with the exception of the period before signing onto the plan and deductible/co-pays afterward, which would be minimal under the platinum plan). But there are many risks involved with the latter idea, obviously. What if that person requires immediate hospitalization and surgery for some reason (which could not wait the month or so needed to get onto the exchange before beginning treatment)? Say, a burst appendix, or if they were badly injured in an auto collision that they caused? (If they caused the collision, then there would be no auto insurance coverage available, except for MEDPAY, which most people do not have). Or, in your cancer scenario, would you want to wait a whole month before beginning treatment, and potentially die as a result, before beginning treatment, just to avoid the costs in the interim? That first month could be extraordinarily expensive. All it would take is one medical problem like this to make the alleged “free-rider”'s plan a disaster. ---
**Author:** ![jasg](https://avatars.discourse-cdn.com/v4/letter/j/f0a364/32.png) [@jasg](https://boards.straightdope.com/u/jasg)\ **Post date:** [November 21, 2013, 9:07pm UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/744 "2013-11-21T21:07:37Z")
Buying coverage after you get sick is going to be rather tricky… After this initial signup, you will have to be able to wait for an open enrollment [period](https://www.healthcare.gov/glossary/open-enrollment-period/) (Oct 15 - Dec 7) and then wait until Jan 1 for treatment. Would suck to break a leg snow boarding on Dec 8th and need to get coverage. ---
**Author:** ![DonnieBarko](https://avatars.discourse-cdn.com/v4/letter/d/e19adc/32.png) [@DonnieBarko](https://boards.straightdope.com/u/DonnieBarko)\ **Post date:** [November 21, 2013, 9:18pm UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/745 "2013-11-21T21:18:48Z")
> [@](#): > > Buying coverage after you get sick is going to be rather tricky… After this initial signup, you will have to be able to wait for an open enrollment period (Oct 15 - Dec 7) and then wait until Jan 1 for treatment. You can still buy an off-exchange plan at any time during the year. Like those plans that are on the exchange, off-exchange plans cannot deny coverage for pre-existing conditions. The only substantive difference between an on-exchange and off-exchange plan is that only through the exchanges can you receive a federal subsidy. See [http://www.hlntv.com/article/2013/10/03/obamacare-health-reform-new-exchange-requirements](http://www.hlntv.com/article/2013/10/03/obamacare-health-reform-new-exchange-requirements) ---
**Author:** ![alec6542](https://avatars.discourse-cdn.com/v4/letter/a/a8b319/32.png) [@alec6542](https://boards.straightdope.com/u/alec6542)\ **Post date:** [November 21, 2013, 10:32pm UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/746 "2013-11-21T22:32:21Z")
> [@DonnieBarko](#): > > Or, in your cancer scenario, would you want to wait a whole month before beginning treatment, and potentially die as a result, before beginning treatment, just to avoid the costs in the interim? That first month could be extraordinarily expensive. > > All it would take is one medical problem like this to make the alleged “free-rider”'s plan a disaster. Well my scenario is different. I was denied health insurance not because of a pre-existing condition, but rather, a “non-existing, but past condition”. I had cancer two decades ago, but now I am 100% healthy, no problems, nothing. Not allowing insurance companies to discriminate based on distant past conditions is a good aspect of the law. However, I am worried about allowing people with true, pre-existing conditions being able to get insurance. Not because I have no compassion, but because the law puts everyone else into the same risk pool as these people, the premiums are going to sky-rocket as a result, which could dismantle the entire model. Like you said, the individual mandate is crucial for the math behind it to work out, but unfortunately incompetence and partisan politics is going dismantle the whole thing, not allowing it to rollout according to design, which is a shame. ---
**Author:** ![jasg](https://avatars.discourse-cdn.com/v4/letter/j/f0a364/32.png) [@jasg](https://boards.straightdope.com/u/jasg)\ **Post date:** [November 21, 2013, 10:38pm UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/747 "2013-11-21T22:38:20Z")
> [@DonnieBarko](#): > > You can still buy an off-exchange plan at any time during the year. Like those plans that are on the exchange, off-exchange plans cannot deny coverage for pre-existing conditions. The only substantive difference between an on-exchange and off-exchange plan is that only through the exchanges can you receive a federal subsidy. > > See [http://www.hlntv.com/article/2013/10/03/obamacare-health-reform-new-exchange-requirements](http://www.hlntv.com/article/2013/10/03/obamacare-health-reform-new-exchange-requirements) Your link does not say anything about a lack of open enrollment periods. Section 2702 of the legislation establishes open enrollment periods but does not seem to limit them to Exchange policies only. It explicitly allows each “issuer” to establish the open enrollment period. I doubt that any will skip them. [Here](http://www.zanebenefits.com/blog/bid/325646/FAQ-What-If-I-Miss-Open-Enrollment-for-an-Individual-Health-Plan) a cite backing up the concept of restrictions on open enrollment. [Quote=ZaneBenefits blog] This is the first time individual health insurance has had an open enrollment period. It is needed because all individual health insurance plans (‘qualified health plans’) are now guaranteed-issue. Without the open enrollment periods, people would just wait to buy coverage until they got sick or needed an expensive medical procedure. [/Quote] Here is [another](https://www.ehealthinsurance.com/affordable-care-act/news/open-enrollment-the-basics), from [eHealthInsurance.com](http://eHealthInsurance.com) - a site where you can buy insurance outside the Exchanges. > [@eHealthInsurance.com](#): > > - > > What happens if I don’t purchase during the open enrollment period? \* > > – Outside of open enrollment, your ability to apply for health insurance may vary from state to state. It may be limited to the occurrence of a qualifying event, such as the loss of a job, a marriage or divorce, a move, or the birth of a child. > > _What if I miss open enrollment and don’t have a qualifying event?_ > > – You may be able to purchase a non-compliant plan or a short-term health insurance plan, but these won’t meet the standards of the Affordable Care Act and their benefits will likely not be as comprehensive. I am about to purchase a short-term policy for one month. Based on the restrictions I see, I would not buy it if I were already ill. ---
**Author:** ![Fear\_Itself](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/fear_itself/32/19637_2.png) [@Fear\_Itself](https://boards.straightdope.com/u/Fear_Itself)\ **Post date:** [November 21, 2013, 10:44pm UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/748 "2013-11-21T22:44:29Z")
> [@alec6542](#): > > I am worried about allowing people with true, pre-existing conditions being able to get insurance. Not because I have no compassion, but because the law puts everyone else into the same risk pool as these people… So you don’t believe the healthy should pay for the sick? If not the healthy, then who? ---
**Author:** ![adaher](https://avatars.discourse-cdn.com/v4/letter/a/dec6dc/32.png) [@adaher](https://boards.straightdope.com/u/adaher)\ **Post date:** [November 22, 2013, 12:09am UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/749 "2013-11-22T00:09:25Z")
Hmmm, perhaps a change from individual underwriting to risk pooling should have been debated in the open before the bill passed, rather than now? ---
**Author:** ![alec6542](https://avatars.discourse-cdn.com/v4/letter/a/a8b319/32.png) [@alec6542](https://boards.straightdope.com/u/alec6542)\ **Post date:** [November 22, 2013, 1:53am UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/750 "2013-11-22T01:53:40Z")
> [@Fear\_Itself](#): > > So you don’t believe the healthy should pay for the sick? If not the healthy, then who? Well that’s a good question, I suppose that is a political question, but, as a left leaning moderate, I do believe in some degree of redistribution of healthcare costs. I am just worried that Obamacare cannot weather the political backlash. If everyone, the media, the politicians, etc. would just shut up and focus on something else, and allow people to properly enroll in the exchanges with a working website, including those who had their substandard plans cancelled, as well as the right percentage of young people opt in instead of paying the fine, then yes, the numbers would be there ,actuarially speaking, for the program to work. But of course, that’s not what’s happening. Instead, we have an entire political party completely dedicated to the plan’s failure. We have a website that doesn’t work. We have young people everywhere who are opting to pay the fine instead of enrolling (anecdotally speaking). We have premiums very likely to be sky-rocketing for everyone. This is why I fear it won’t work. But hey, I could be wrong, and as I mentioned earlier with my story, personally benefit by being wrong. ---
**Author:** ![Omg\_a\_Black\_Conservative](https://avatars.discourse-cdn.com/v4/letter/o/7ba0ec/32.png) [@Omg\_a\_Black\_Conservative](https://boards.straightdope.com/u/Omg_a_Black_Conservative)\ **Post date:** [November 22, 2013, 2:02am UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/751 "2013-11-22T02:02:39Z")
> [@Fear\_Itself](#): > > So you don’t believe the healthy should pay for the sick? If not the healthy, then who? The people who, themselves, are sick. ---
**Author:** ![Fear\_Itself](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/fear_itself/32/19637_2.png) [@Fear\_Itself](https://boards.straightdope.com/u/Fear_Itself)\ **Post date:** [November 22, 2013, 2:27am UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/752 "2013-11-22T02:27:59Z")
> [@Omg\_a\_Black\_Conservative](#): > > The people who, themselves, are sick. So you don’t believe in insurance that spreads the risk? That’s pretty much how insurance works, you know; everyone pays in, the sick get benefits. ---
**Author:** ![Terr](https://avatars.discourse-cdn.com/v4/letter/t/839c29/32.png) [@Terr](https://boards.straightdope.com/u/Terr)\ **Post date:** [November 22, 2013, 2:29am UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/753 "2013-11-22T02:29:57Z")
> [@Fear\_Itself](#): > > So you don’t believe in insurance that spreads the risk? That’s pretty much how insurance works, you know; everyone pays in, the sick get benefits. The way insurance that spreads the risk works is: everyone pays in, everyone has the same risk (or the premiums are proportionate to the risk), those that get unlucky get benefits. That’s not the way Obamacare works, is it? ---
**Author:** ![Lok](https://avatars.discourse-cdn.com/v4/letter/l/e8c25b/32.png) [@Lok](https://boards.straightdope.com/u/Lok)\ **Post date:** [November 22, 2013, 5:06am UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/754 "2013-11-22T05:06:01Z")
> [@Terr](#): > > The way insurance that spreads the risk works is: everyone pays in, everyone has the same risk (or the premiums are proportionate to the risk), those that get unlucky get benefits. > > That’s not the way Obamacare works, is it? Well, except that it does that by requiring people to buy insurance from private companies, yeah, that is how the ACA works. That is in fact the central core of the ACA. ---
**Author:** ![Terr](https://avatars.discourse-cdn.com/v4/letter/t/839c29/32.png) [@Terr](https://boards.straightdope.com/u/Terr)\ **Post date:** [November 22, 2013, 5:40am UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/755 "2013-11-22T05:40:42Z")
> [@Lok](#): > > Well, except that it does that by requiring people to buy insurance from private companies, yeah, that is how the ACA works. Wrong. Read what I wrote again. ---
**Author:** ![adaher](https://avatars.discourse-cdn.com/v4/letter/a/dec6dc/32.png) [@adaher](https://boards.straightdope.com/u/adaher)\ **Post date:** [November 22, 2013, 7:14am UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/756 "2013-11-22T07:14:13Z")
The idea that high risk individuals are subsidized by low risk individuals is unique to ACA. We don’t do that with any other type of insurance. If you live in an area prone to hurricanes, you’ll pay more for insurance than someone living in Wyoming. Apparently, many Dopers believe this is unjust. ---
**Author:** ![2ManyTacos](https://avatars.discourse-cdn.com/v4/letter/2/3da27b/32.png) [@2ManyTacos](https://boards.straightdope.com/u/2ManyTacos)\ **Post date:** [November 22, 2013, 2:59pm UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/757 "2013-11-22T14:59:46Z")
I’m getting so sick of this stupid fucking logic. So now, apparently EVERY SINGLE fucking election we have is supposed to be a referendum on the ACA, and well…if it doesn’t go the Republicans’ way, then actually it’s the NEXT election that’ll prove just how right the GOP is. :dubious: Stupid, stupid, stupid, stupid, stupid argument. ---
**Author:** ![iiandyiiii](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/iiandyiiii/32/7924_2.png) [@iiandyiiii](https://boards.straightdope.com/u/iiandyiiii)\ **Post date:** [November 22, 2013, 3:05pm UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/758 "2013-11-22T15:05:14Z")
> [@adaher](#): > > The idea that high risk individuals are subsidized by low risk individuals is unique to ACA. We don’t do that with any other type of insurance. You are incorrect- we do this with Social Security. And depending on how you define various terms, we do this with Medicare and Medicaid as well. ---
**Author:** ![adaher](https://avatars.discourse-cdn.com/v4/letter/a/dec6dc/32.png) [@adaher](https://boards.straightdope.com/u/adaher)\ **Post date:** [November 22, 2013, 11:52pm UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/759 "2013-11-22T23:52:29Z")
> [@2ManyTacos](#): > > I’m getting so sick of this stupid fucking logic. > > So now, apparently EVERY SINGLE fucking election we have is supposed to be a referendum on the ACA, and well…if it doesn’t go the Republicans’ way, then actually it’s the NEXT election that’ll prove just how right the GOP is. :dubious: > > Stupid, stupid, stupid, stupid, stupid argument. Big issues are big issues until settled. Presumably there won’t be too many more elections where ACA is a big issue, becuase it will either work well or it will fail. ---
**Author:** ![adaher](https://avatars.discourse-cdn.com/v4/letter/a/dec6dc/32.png) [@adaher](https://boards.straightdope.com/u/adaher)\ **Post date:** [November 22, 2013, 11:53pm UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/760 "2013-11-22T23:53:57Z")
> [@iiandyiiii](#): > > You are incorrect- we do this with Social Security. And depending on how you define various terms, we do this with Medicare and Medicaid as well. Those are single payer government programs and while many are ignorant of how they work, their fundamental nature is not concealed. Whereas with ACA, it was NOT sold as a program where the healthy subsidize the sick. It was sold as a program where “If you already have insurance, all that changes for you is that it will be better and cost less.” ---
**Author:** ![LC\_Strawhouse](https://avatars.discourse-cdn.com/v4/letter/l/e19adc/32.png) [@LC\_Strawhouse](https://boards.straightdope.com/u/LC_Strawhouse)\ **Post date:** [November 23, 2013, 8:33pm UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/761 "2013-11-23T20:33:57Z")
> [@alec6542](#): > > I am seriously conflicted on this. No doubt Obamacare is a train wreck, but, due do one of the most egregious practices of the health insurance industry, Obamacare at present is the ONLY way I can get insurance. Nothing to add except: if the rule’s biggest snag is, seriously, a website that’s not rolling out on schedule, then the “trainwreck” aspect is a fake controversy that will soon be completely forgotten. [Previous page](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561.md?page=37) [Next page](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561.md?page=39)