# 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:** 9
**Author:** ![adaher](https://avatars.discourse-cdn.com/v4/letter/a/dec6dc/32.png) [@adaher](https://boards.straightdope.com/u/adaher)\ **Post date:** [June 14, 2013, 8:49am UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/161 "2013-06-14T08:49:27Z")
I will say one good thing about ACA though, these high deductible plans are going to do wonders for keeping costs down. this is essentially what conservatives wanted, more cost sharing so consumers had skin in the game. ---
**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:** [June 14, 2013, 8:52am UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/162 "2013-06-14T08:52:56Z")
> [@adaher](#): > > I will say one good thing about ACA though, these high deductible plans are going to do wonders for keeping costs down. this is essentially what conservatives wanted, more cost sharing so consumers had skin in the game. These “high deductibles” are much lower than the “high deductible” plans currently available in the individual insurance market. ---
**Author:** ![adaher](https://avatars.discourse-cdn.com/v4/letter/a/dec6dc/32.png) [@adaher](https://boards.straightdope.com/u/adaher)\ **Post date:** [June 14, 2013, 9:16am UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/163 "2013-06-14T09:16:24Z")
I doubt that, but we’ll see how people react to the rates. If the deductible is lower, then the premium has to be higher. ---
**Author:** ![Typo\_Knig](https://avatars.discourse-cdn.com/v4/letter/t/cdc98d/32.png) [@Typo\_Knig](https://boards.straightdope.com/u/Typo_Knig)\ **Post date:** [June 14, 2013, 11:18am UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/164 "2013-06-14T11:18:35Z")
When everyone is insured - and paying into the system - the costs per person are much less. The very low rates just announced for California are examples. It wouldn’t surprise me if their most expensive plan is cheaper and more comprehensive that the cheapest policy available to individuals under the pre-ACA system. I would say most people with insurance are happy to have coverage, but are really pissed off at the bureaucratic reject-every-claim-opoly part that takes up 90% of patients’ time. The scene in The Incredibles where Bob Parr talks an elderly lady through how to get her claim paid - audiences applauded. The scene in As Good As It Gets where Helen Hunt’s character _finally_ gets a coherent diagnosis and treatment plan for her son, and said “Goddamn fucking HMOs” - people cheered. People in the US like having insurance, but they hate their insurer. Not because their insurer denies gold-plated nose jobs, but because their insurer denies life-saving treatments that are explicitly covered in the text of the plan. ---
**Author:** ![Really\_Not\_All\_That\_Bright](https://avatars.discourse-cdn.com/v4/letter/r/e8c25b/32.png) [@Really\_Not\_All\_That\_Bright](https://boards.straightdope.com/u/Really_Not_All_That_Bright)\ **Post date:** [June 14, 2013, 1:39pm UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/165 "2013-06-14T13:39:20Z")
> [@adaher](#): > > If a brain drain happened in Congress, would we notice? If everyone in Congress leaves the average IQ will go _up_. ---
**Author:** ![bouv](https://avatars.discourse-cdn.com/v4/letter/b/bc8723/32.png) [@bouv](https://boards.straightdope.com/u/bouv)\ **Post date:** [June 14, 2013, 3:31pm UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/166 "2013-06-14T15:31:49Z")
> [@adaher](#): > > that’s the thing, most people are happy with their insurance. They’re happy with the insurance because the alternative is usually _nothing._ And when you come from nothing, you might not even realize there are better ones out there. For instance: I just started a new job. Most people here are happy with their insurance. It’s a tech start-up, so lots of younger people who’ve only ever worked here, or maybe one other place before. But truth be told, it’s a shitty plan. It’s high deductible ($3000 for a single person,), medium-low premium ($65 per two-week paycheck,) and not good coverage…lots of “in-network” and “pre-approval” shit. But again, lots of them are happy with it, because compared to no insurance, it’s a God-send. But I came from a job with some of the best health insurance I’ve ever seen. It was low-premium ($35 per paycheck,) no deductible, and super-low co-pays ($10 for regular office visit, $15 for specialist, no referral needed, $50 for ER visit, $200 per in-patient day, $300 for surgery, and there was a max out-of-pocket expense for those, too. No “max lifetime benefit” crap, either.) So it’s a little mis-leading to say that most people are happy with their insurance when they both 1. Don’t know any better and 2) Are pretty much stuck with that insurance anyway because it’s tied to employer and you’re lucky if you actually have a choice in plans. I find it sickening that the US doesn’t have UHC. From both a practical/economic standpoint, it makes sense, and from a moral standpoint it makes sense. ---
**Author:** ![Buck\_Godot](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/buck_godot/32/6573_2.png) [@Buck\_Godot](https://boards.straightdope.com/u/Buck_Godot)\ **Post date:** [June 14, 2013, 4:10pm UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/167 "2013-06-14T16:10:48Z")
> [@adaher](#): > > that’s the thing, most people are happy with their insurance. ACA is successful politically if most people continue to be happy with their insurance. If people lose their insurance or the cost increases dramatically, it will be unsuccessful. You can’t base the effectiveness of insurance based only how the majority feels about it. Most people don’t actually use their insurance for other than the occasional doctor visit. For these people a insurance plan that cost half as much but never made payment would put them ahead financially. In order to gauge the effectiveness of insurance you need to pay attention to the low minority for whom insurance is actually designed. Most people don’t actually know whether their insurance would pay if they actually got cancer, or whether instead they would lose their house. It is also the case that the majority of people don’t have per-existing conditions that make them uninsurable, even though those are the people who need insurance the most. Leaving them out of the equation is like saying we don’t need to legalize gay marriage because the majority of Americans can get married just fine. ---
**Author:** ![adaher](https://avatars.discourse-cdn.com/v4/letter/a/dec6dc/32.png) [@adaher](https://boards.straightdope.com/u/adaher)\ **Post date:** [June 15, 2013, 12:10am UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/168 "2013-06-15T00:10:22Z")
Your argument allows for the possibility of ACA supporters seeing the law as a success at the same time that voters reject it. But I say that a truly successful health care program earns the loyalty of voters. ACA must end up either allowing the majority to keep their current insurance, or acquire better-valued insurance. If people either see a drop in quality, or an increase in prices, they will not regard the program as a success. Especially since cost drops were part of the sale of the bill. We can talk about how the GOP has oversold the likely problems with the bill, but supporters also built up tremendous expectations. Since the bill has passed though, the Democrats have been furiously trying to lower expectations, which alone says that the GOP was right in many ways. ---
**Author:** ![GIGObuster](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/gigobuster/32/421_2.png) [@GIGObuster](https://boards.straightdope.com/u/GIGObuster)\ **Post date:** [June 15, 2013, 12:52am UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/169 "2013-06-15T00:52:48Z")
> [@adaher](#): > > We can talk about how the GOP has oversold the likely problems with the bill, but supporters also built up tremendous expectations. Since the bill has passed though, the Democrats have been furiously trying to lower expectations, which alone says that the GOP was right in many ways. That is like the baseball Tigers claiming that since the Giants are lowering expectations it means that the Tigers were correct in many ways… And then the Tigers call it a day, But that is why they play the games… ---
**Author:** ![adaher](https://avatars.discourse-cdn.com/v4/letter/a/dec6dc/32.png) [@adaher](https://boards.straightdope.com/u/adaher)\ **Post date:** [June 15, 2013, 1:03am UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/170 "2013-06-15T01:03:21Z")
Well, yeah. In the end people will judge the law based on how it affects them. If they gain affordable insurance when they didn’t have access to it before, that’s a plus. If they lose their insurance or see their rates go up, that’s a minus. ---
**Author:** ![GIGObuster](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/gigobuster/32/421_2.png) [@GIGObuster](https://boards.straightdope.com/u/GIGObuster)\ **Post date:** [June 15, 2013, 1:33am UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/171 "2013-06-15T01:33:11Z")
> [@adaher](#): > > Well, yeah. In the end people will judge the law based on how it affects them. If they gain affordable insurance when they didn’t have access to it before, that’s a plus. If they lose their insurance or see their rates go up, that’s a minus. Of course, and once again your early hyperbole is really silly, specially when most of Obamacare was once a Republican plan. The wrongness of the Republicans in this subject is asinine. ---
**Author:** ![adaher](https://avatars.discourse-cdn.com/v4/letter/a/dec6dc/32.png) [@adaher](https://boards.straightdope.com/u/adaher)\ **Post date:** [June 15, 2013, 3:20am UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/172 "2013-06-15T03:20:07Z")
If it works, that means we can take credit for the idea. Duh. ---
**Author:** ![GIGObuster](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/gigobuster/32/421_2.png) [@GIGObuster](https://boards.straightdope.com/u/GIGObuster)\ **Post date:** [June 15, 2013, 5:16am UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/173 "2013-06-15T05:16:45Z")
> [@adaher](#): > > If it works, that means we can take credit for the idea. Duh. Too late for that, most of the organizations that promoted that option in the 90’s now tell others that it is not a good idea now; as Romney could tell you, the only difference is that it is the Democrats (And a few more capable Republican governors) the ones that are working to follow the law now. It is worse when the House Republicans show that they have time mostly to continue to do useless votes to repeal the law: > **[Politics | News from The Advocate](https://www.theadvocate.com/baton_rouge/news/politics/)** > > Read the latest political news in Baton Rouge, East Baton Rouge Parish and the state of Louisiana from The Advocate. ---
**Author:** ![2ManyTacos](https://avatars.discourse-cdn.com/v4/letter/2/3da27b/32.png) [@2ManyTacos](https://boards.straightdope.com/u/2ManyTacos)\ **Post date:** [June 17, 2013, 11:34pm UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/174 "2013-06-17T23:34:34Z")
**Adaher** , what are you going to do now that the ACA is _finally_ going to be widely promoted in a [positive light?](http://www.politico.com/story/2013/06/ofa-launches-obamacare-campaign-92893.html?hp=l9) From the article: _“Organizing for Action is launching its first television advertising campaign, highlighting the many [ways] the Affordable Care Act [is]already improving the quality of healthcare, driving down costs, and will provide coverage to millions of uninsured Americans,” Playbook’s Mike Allen reported, quoting a release. “Coupled with on the ground organizing, OFA is working on a major education campaign as the health care law moves towards full implementation.”_ For years, the only widespread discussion of the ACA in the greater zeitgeist has been on behalf of the GOP, who has (for the most part, successfully) crafted this illusion of the ACA existing in some sort of abstract vacuum, paving the way for all of the asinine sky-is-falling predictions that we talked about earlier. And honestly, I fault the administration and the Dems for running away from the ACA for three years just as much as I blame the Republicans for their dumbass fear-mongering. It’s a double-edged sword, really; the Democrats stupidly drafted the ACA to not even take effect until **four fucking years** after it passed, and that created the marketing issue in terms of how the administration could’ve possibly defended the law against GOP lies when most of the benefits were always years away from actualization. And of course, the idiotic four-year implementation schedule afforded 37 pointless repeal votes, dozens of lawsuits, a Supreme Court decision, and a presidential election. How will you react now that people are FINALLY going to be forcefully told about the ACA benefits? ---
**Author:** ![adaher](https://avatars.discourse-cdn.com/v4/letter/a/dec6dc/32.png) [@adaher](https://boards.straightdope.com/u/adaher)\ **Post date:** [June 17, 2013, 11:44pm UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/175 "2013-06-17T23:44:19Z")
That is actually false. The pharmaceutical companies spent $150 million promoting ACA: > **[Memos Unveil How White House Worked With PhRMA To Sell Obamacare](https://abcnews.go.com/blogs/politics/2012/06/memos-unveil-how-white-house-worked-with-phrma-to-sell-obamacare/)** > > Get breaking national and world news, broadcast video coverage, and exclusive interviews. Find the top news online at ABC news. Didn’t move the needle an inch. ---
**Author:** ![GIGObuster](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/gigobuster/32/421_2.png) [@GIGObuster](https://boards.straightdope.com/u/GIGObuster)\ **Post date:** [June 18, 2013, 1:02am UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/176 "2013-06-18T01:02:39Z")
I see that as smart, if not much effective advertisement, the smart part is how to get some giants to fight against other giants. One has to remember that with the costs of healthcare headed to 20% or more of the USA GDP, the current irrational system was unsustainable, eventually the bubble that it is would burst and even big Pharma would lose a lot, so Obamacare was seen by them as insurance against that eventual failure. However, I have to say that I’m impressed at the white house negotiators: > **[Study: Obamacare is a net loss for pharmas](https://www.mmm-online.com/home/channel/study-obamacare-is-a-net-loss-for-pharmas/)** > > An analysis by PricewaterhouseCoopers projects Affordable Care Act-related revenue gains of only $15 billion and tabulates a net loss of $140 billion for pharmas under the law > [@](#): > > Study: Obamacare is a net loss for pharmas > > One of the main assumptions underlying the deal PhRMA cut with the White House and Senate Democrats on the Affordable Care Act (ACA) was that as 30-plus million formerly uninsured gained coverage, drug utilization would increase and drug company revenue gains would alleviate and maybe even outpace agreed-upon industry sacrifices. > [@](#): > > The industry’s sacrifices also bought pharmas a seat at the table as the bill was being hashed out, letting PhRMA negotiators nix deal-breakers like legalizing importation of drugs from Canada and other countries, or various price control schemes—though the trade group was unable to head off the implementation of the Independent Payment Advisory Board for Medicare. Unlike the less-cooperative device industry, on which the White House and Senate negotiators levied a harsh 2.3% excise tax, PhRMA got some say in how it would help make the law revenue-neutral, and much of the drug industry’s contribution is going towards shoring up the Medicare Part D prescription drug benefit, which has provided a nice boost to utilization. > > Those intangibles will be cold comfort to the biopharma bigs that felt Tauzin gave away the store in his dealings with the White House. Tauzin left PhRMA abruptly in February 2010, before the bill was passed and at a time when it looked like it might not make it. One thing I think one can get from this: One of the big reasons for the shortfall for big pharma is the states that are refusing to implement the changes, I do think that the giant here will get more active on telling those conservatives how bad for business they really are. As I saw it before, eventually prices will have to be controlled better, but, one war a time, please. ---
**Author:** ![Tethered\_Kite](https://avatars.discourse-cdn.com/v4/letter/t/a5b964/32.png) [@Tethered\_Kite](https://boards.straightdope.com/u/Tethered_Kite)\ **Post date:** [June 18, 2013, 3:00am UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/177 "2013-06-18T03:00:23Z")
Do you know what a _pig in a poke_ is? That’s what I think. Whether it proves to be a nice fat little piggy or some erysipelas-ridden runt remains to be seen. ---
**Author:** ![2ManyTacos](https://avatars.discourse-cdn.com/v4/letter/2/3da27b/32.png) [@2ManyTacos](https://boards.straightdope.com/u/2ManyTacos)\ **Post date:** [June 18, 2013, 5:41pm UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/178 "2013-06-18T17:41:48Z")
[I find this pending legal case against the ACA wildly entertaining.](http://www.californiahealthline.org/road-to-reform/2013/could-this-little-watched-court-case-sink-obamacare.aspx) From the article: _According to Adler and Cannon, the ACA’s authors intentionally chose to exclude subsidies for federal exchanges – an attempt to dangle a carrot for states to run their own exchanges, they contend. In their eyes, the IRS is acting illegally without congressional authorization._ Okie dokie. :dubious: Still, keep an eye on it. In related news, my state finally [passed the Medicaid expansion a few days ago.](http://www.nytimes.com/2013/06/16/health/california-to-expand-medicaid.html?_r=0) I think I’ve said it before, but if the ACA isn’t able to succeed in CA - where, by all accounts, the law has been the most aggressively implemented - then it really can’t work anywhere. Hell, I’ve never been the biggest fan of this state to begin with, but I’m happy that we’re actually pursuing the law here instead of trying to sabotage it. ---
**Author:** ![adaher](https://avatars.discourse-cdn.com/v4/letter/a/dec6dc/32.png) [@adaher](https://boards.straightdope.com/u/adaher)\ **Post date:** [June 18, 2013, 8:50pm UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/179 "2013-06-18T20:50:57Z")
If that’s what the law says, that subsidies only go to state exchanges, then it’s open and shut. ---
**Author:** ![GIGObuster](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/gigobuster/32/421_2.png) [@GIGObuster](https://boards.straightdope.com/u/GIGObuster)\ **Post date:** [June 18, 2013, 10:54pm UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/180 "2013-06-18T22:54:26Z")
> [@adaher](#): > > If that’s what the law says, that subsidies only go to state exchanges, then it’s open and shut. As usual, Republicans are not looking at the unintended consequences. [http://healthaffairs.org/blog/2012/07/18/tax-credits-in-federally-facilitated-exchanges-are-consistent-with-the-affordable-care-acts-language-and-history/](http://healthaffairs.org/blog/2012/07/18/tax-credits-in-federally-facilitated-exchanges-are-consistent-with-the-affordable-care-acts-language-and-history/) > [@](#): > > Those who oppose making affordable health insurance available to lower- and middle-income Americans are not giving up easily. Having lost their two-year long battle to have the Affordable Care Act nullified in its entirety by the federal courts, opponents have come up with a new theory that they believe will at least deprive millions of middle-income Americans of the tax credits that Congress has offered through the ACA to help make health insurance affordable. > > While this theory has little chance in succeeding in the courts, and even less chance of being addressed by the courts anytime in the near future because of jurisdictional problems, it may very well convince conservative state legislators and governors to refuse to establish health insurance exchanges in their states. This would in turn lead to the establishment of federally facilitated exchanges in states that decide not to establish their own exchanges. Thus, ironically, we see the spectacle of ACA opponents fighting for increased taxes on the middle class and for a greater federal government “takeover” of health insurance markets. [Previous page](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561.md?page=8) [Next page](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561.md?page=10)