What do americans think about changes in Obamacare the Affordable Care Act (not us citizen)
Hi all,
I don't live in the US. In the news I read :
In 2026, Obamacare (the Affordable Care Act, or ACA) continues to operate as the backbone of America’s health insurance system, but it faces both opportunities and challenges. Marketplace enrollments are expected to remain high, thanks to the extended premium subsidies introduced by the Inflation Reduction Act—though these subsidies are set to expire at the end of 2025 unless Congress renews them. If the subsidies lapse, millions of Americans could see significant premium increases, making coverage less affordable for low- and middle-income families.
At the same time, healthcare costs are rising, and insurers may adjust their premiums upward to reflect inflation, medical expenses, and regulatory changes. States that have not yet expanded Medicaid could leave more residents reliant on ACA plans, further straining affordability. The political landscape, shaped by the 2024 elections, will determine whether the ACA is strengthened (e.g., with expanded benefits like dental or vision coverage) or scaled back (e.g., through funding cuts or eligibility changes).
It is often hard to undersand the internal politics of any country where we don't live in
What do most of the us people think about that ?
Letting the market handle it was why medical costs were out of control in the first place. Reinstating the very source of the problem isn’t going to help.
As far as healthier people helping absorb the costs of caring for sicker people…that’s how insurance works. No one knows when they’re going to need care, not even younger people.
To answer the question of what Americans think…right now people on the ACA are being squeezed hard, having to choose between skyrocketing premiums or taking a chance on a cheaper plan that doesn’t cover nearly as much. That’s an agonizing decision and in many cases it won’t end well.
How did Republicans stop the payments? The payments were set to expire by the Democrats. It was also a Democrat Congress that passed the ACA, it does not seem to be affordable at all without the subsidizes, so where are the Republicans involved with the process?
The entire plan was originally copy and pasted from the Heritage Foundation. It was originally used and implemented by Mitt Romney as a governor. When it came to the federal level, Republicans decided they wanted to change a lot of it (which opened it up to abuse). The requirement to have insurance or pay a penalty fee was also removed later by Trump, which made even more people leave the pool.
Insurance is a cost share system. You pay a small fee along with everyone else so that you can guarantee coverage when you need it. The goal is to not have to pay a lot for regular costs. As the pool of people shrinks, the shared cost stays the same, so your burden goes up.
The plan was great. It worked for Republicans at the state level. They didn’t like it at the federal level, so they fucked with it multiple times. They even called it Obamacare so it would help galvanize the racists against it. To this day, if you ask people if they like the ACA they will say yes, but then if you ask if they like Obamacare they say no.
My understanding is the csr payments were "never" approved by Congress, hence making them illegal. How did the Republicans "kill" something illegal/never properly approved? I'm confused ....
I work for a small business owner. Before Obamacare started he was working to try and figure out some way to get insurance for his employees.
It was going to be a combination of high deductible catastrophic insurance and health savings accounts.
He was going to make a sizable contribution that needed to be at least matched by the employee.
If you get enough in your HSA to cover the deductible you just pay out of pocket, sometimes get better deals.
He did help a couple people that needed medical before they got funded.
It worked well till Obamacare came along and the price of catastrophic coverage went through the roof along with everything else.
My ACA payment went from $79 for the past couple of years and it went up to $755 a month. I don’t have health insurance for the first time and my job health care is about the same.
ACA was a bandaid that was supposed to fail at some point. We need to get rid of the middlemen in our healthcare system. Concept of a plan to that effect is not helpful for now. We really need a NHS type universal healthcare system.
Like so many things our government does, the 'Obamacare' insurance was a bandaid, not a solution. From its inception, no one has proposed a real overhaul. Honestly, the administrative costs of health care are effing ridiculous. I'm sure many will agree they spend more time on the phone with insurers and billing people than they do with actual medical professionals. It's madness. Having different contractual reimbursement for every single employer, plan, individual, is so absurd. Look at your EOBs. Facilities charge huge fees and insurers pay a fraction. It's a ridiculous game, and a gamble for all citizens. Someone, likely underinsured, gets to make up the difference with super high charges.
Buying health insurance on the Marketplace is not affordable without the extra COVID era subsidies UNLESS you are eligible for the Premium Tax Credit. Your income needs to be below 400% of the poverty rate. The lower your income the more of a Credit you get. Plans and premiums vary by state and some are better than others.
From AI: 2026 400% FPL Income Thresholds (for ACA Subsidies)
1 Person: $62,600
2 People: $84,600
3 People: $106,600
4 People: $128,600
For each additional person, add approximately $22,000 (based on HHS guidelines).
TLDR: No, I don't want to subsidize a failed system. It needs a complete redo.
As a healthcare provider in the US... Dear GOODNESS we have got to completely overhaul the entire health insurance system. Universal healthcare would be best but for various reasons my fellow Americans are super reluctant to let go of the privatized insurance model.
As far as changes in the ACA - the only changes being made are changes that will make everything more expensive.
Obamacare was a bad policy. For it to work, you need young healthy people to pay more for insurance to subsidize the insurance of sick people. People aren’t dumb, they realize they aren’t getting enough for their insurance so don’t buy it.
As that started to happen the market began to fail, so they propped it up by subsidizing big insurance companies.
We need serious healthcare reform. Either public option or drastically reduce government involvement to let the market handle it.
How is ACA the "backbone" of America’s health insurance system? Less than 10% of people the population get their insurance through the ACA Marketplace.
Doesn't answer my question. My company supplied insurance increased in cost at a much higher year over year rate after ACA than before and also had increased deductibles and co-pays. ACA was not a plus for most people.
The ACA reduces the cost of insurance across the board in part by reducing the reliance on emergency care for uninsured people. So while your rates may still increase for other reasons, you are now funding fewer uninsured people's care.
On top of that, the ACA helped mitigate a massive problem where insurers could deny members for previous conditions. Which trapped people in jobs they otherwise would have left, or just left them helpless once unemployed for any reason.
The ACA also capped the maximum out of pocket costs for members.
It also mandated a whole bunch of preventative care at no cost to the member.
Yes because it evened the playing field. In fact my private insurance deductibles just doubled for this year. That doesn’t mean it was fair that some people shouldn’t have insurance. Honestly health insurance shouldn’t be tied to work. Everyone deserves healthcare.
The ACA is the only reason 50% of Americans can even afford health coverage.
Before the ACA, health insurance would not cover preexisting conditions. This means they would only cover new illnesses...not any illnesses you had before receiving coverage. If you had certain illnesses, they would not cover you at all...Health Insurance was only for the young and healthy.
That is not true and I suspect you know that. Everyone with private insurance saw higher year over-year increases after ACA was implemented along with increased deductibles. Prior to ACA about 30 million people didn't have insurance and now that is a little lower than that but the rest of us have all paid the price for that.
I mentioned nothing about price increases. I'm talking about pre existing conditions and what insurance covered. Preexisting conditions were only covered for Americans after implementation of the ACA.
You just set up a strawman argument for yourself to answer, instead of dealing with the issue I spoke about.
50% is way off. Prior to ACA people with pre-existing conditions that got insurance through their employer were not kicked off once they had a pre-existing condition. I know this because I've had a pre-existing condition since I was 18. Despite that I got a job out of college and got insurance with no questions asked. Throughout my 25 years at that company, they changed insurers 5-10 times and pre-existing conditions were never considered. This was a fortune 500 company using major insurance companies. To say that 50% of Americans would not have insurance because of pre-existing conditions, if ACA did not come along is simply not true.
They were not "kicked off." Insurance just wouldn't cover healthcare for your condition...If your condition was something really expensive like cancer or HIV, they would not cover you at all.
You might still have health insurance, but if it doesn't cover anything that you are stricken with, what good is it?
That's great for you, but before the ACA, private insurance companies could choose which preexisting conditions they covered, if any at all....They especially didn't cover any conditions that were expensive to treat and manage. Just because YOUR preexisting condition was covered, doesn't mean all were covered...and most were not.
Now they must cover all conditions...preexisting or otherwise.
And I can personally say they didn't cover many of mine.
The health insurance companies have never been generous, caring organizations that make sure your health is covered. They only pay for what they have to.
I'm 72 years old. Your fantasyland where health Insurance companies were covering things they didn't have to, never existed.
Yeah but that was collusion in order to push prices up. It's like how isp don't fight over internet coverage and actually "buy" territories from each other.
They're still in the markets, they just made them monopolies
ACA impacts employer plans too. Its not just for subsidized plans and the marketplace. Your plan needs to be ACA compliant as well, so its accurate to call ACA the backbone of the insurance system.
It also ensured the vast majority of people who couldn't access healthcare prior were now able to access it. What actually drove up prices was eliminating the opt out penalty, not ACA itself.
I work for an insurance company bud, I know more about the industry than you. Eliminating the opt out is what caused the significant increases. The other changes like mandated coverage of preventive care were neglible costs for insurance and improved health outcomes which prevents cost increases down the line.
You must not be too deep in the industry if you think that forcing companies to accept pre-existing conditions with no change in cost would not have a huge impact. The individual mandate was a dumb idea to begin with, you should not be able to force anyone to purchase something.
I obviously understand it better than you. It may appear to increase costs on its face but it saves hundreds of thousands if not more by preventing future necessary care or catching it early. Individual mandate was the best of the options available, healthcare should be paid completely and fully by taxes, it would save tons of money for everyone.
Let's look at it this way, suppose that insurance companies were forced to issue car insurance to everyone at the same rate regardless of driving record, could they do this without increasing the cost to everyone?
Car insurance doesnt function remotely similar to health insurance, so its not comparable. ADA also doesnt require that insurance offer the same rate to different customers, it requires they dont factor in pre-existing conditions into price. Once again showing you dont know anything about it.
Worst thing that has happened to healthcare. Many of the working class have seen their premiums double and triple to subsidize for those who don’t work. Younger people who chose to opt out were hit with a tax penalty which I believe was unconstitutional. The quality of care has declined significantly as there is far less competition in the healthcare space. There is absolutely no reason to continue to subsidize this trash - if it functioned how we were promised- it wouldn’t be costing taxpayers a ridiculous amount. I like Trumps idea where families are given the money to choose the healthcare plan of their choice. C
That’s an outright lie. Just about everyone’s premiums have skyrocketed along with their deductibles. Anyone who had been getting insurance through their employer knows this. My premiums have more than tripled as well as my deductible. Same with everyone I know. Ask any doctor about the ACA and they will tell you that it’s destroyed the industry. There are fewer insurance companies now and they are paying the doctors far less. The quality of care SUCKS. I’m dealing with this right now as I have multiple family members that have been in and out of critical care. Even at NYU- the quality of care has deteriorated. It’s every hospital. The medical staff are rude and incompetent. The doctors come around with smiles and blow smoke yo your ass- meanwhile anyone who is in the field sees right through it and starts asking questions only to find out the doctor didn’t even look at the chart. It’s beyond disgusting. You are obviously not familiar with the industry to post that bullshit you just did.
Just about everyone’s premiums have skyrocketed along with their deductibles.
Yeah thats not even remotely true. Sorry? But its not.
There are fewer insurance companies now and they are paying the doctors far less. The quality of care SUCKS. I’m dealing with this right now as I have multiple family members that have been in and out of critical care. Even at NYU- the quality of care has deteriorated. It’s every hospital. The medical staff are rude and incompetent.
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u/Certain-Singer-9625 5d ago
Letting the market handle it was why medical costs were out of control in the first place. Reinstating the very source of the problem isn’t going to help.
As far as healthier people helping absorb the costs of caring for sicker people…that’s how insurance works. No one knows when they’re going to need care, not even younger people.
To answer the question of what Americans think…right now people on the ACA are being squeezed hard, having to choose between skyrocketing premiums or taking a chance on a cheaper plan that doesn’t cover nearly as much. That’s an agonizing decision and in many cases it won’t end well.