| Businesses were screaming about double-digit percentage, year over year premium increases for their employees. As I see it, the ACA was a very middle-of-the-road policy initiative. Building upon a Republican governor's program, namely Romney's in Massachusetts. It was meant to appeal to and help business as much as uninsured individuals. It was conservative in that it didn't throw out the existing system of insurance; rather, it brought new customers to the existing insurers. Insurers became enthusiastic about increased marketshare. Law consists of two parts: 1) The law itself, and 2) Paying for it. Republicans made very clear statements about their primary, number one goal (really, the primary goal of their party and their Federal legislative presence) being making Obama's presidency a one term presidency. The ACA was passed, in spite of their opposition. But they used their subsequent control in Congress to not pay for an essential component. The law provided two years of compensation to insurance companies for excessive expenses resulting from ACA Marketplace plans. The idea was to provide a buffer -- government security -- while insurers caught up on the population's deferred medical expenses and built an actuarial understanding of the population. When the insurers sought that compensation, I've been told by a professional working in the industry, they received about 15 cents on the dollar. Premiums shot up. Companies dropped out. Republicans cited the "failure" that they helped create in the first place. This isn't the only aspect of the situation, but it's a very significant one. The ACA wasn't perfect. Work could have been done to improve it. Instead, a lot of political effort went into killing it. Oh, and as tptacek mentioned, it did bring many costs under more control. Something that benefited group plans such as those provide by employers. You don't hear so much about that, eh? Or the enormous profits that insurers are reaping, in spite of complaints about the ACA Marketplace plans. P.S. As I've mentioned before, I'm someone who was denied coverage, at all, outright, prior to the ACA coming into full effect. I had a minor condition that a very well respected surgeon would not operate on, while I was still on a corporate group plan. Risk/benefit favored simply monitoring. That didn't matter. No insurance for me! (Fortunately, a professional and personal contact in the industry pulled some strings. Something NOT available to most people.) P.P.S. I should add that some people think that some insurers may have underpriced their ACA plans a bit, initially, eager to maximize their portion of the increase in market size and relying on the temporary government security for protection. I don't know whether this is true. Even if it is, no law/program is perfect, and the two year timeframe placed an inherent limit on this behavior. When the repayments came up so short (15 cents on the dollar), this might have magnified the corresponding premium increases somewhat. But all this was accounted for by the ACA law, including limiting its effect. It just wasn't, subsequently, paid for by the Federal budget process. And if it is true, it reveals insurer's enthusiasm about the ACA. They wanted the increased marketshare. Instead of working with this momentum, it was thrown under the bus for political reasons. As I see it. |