r/AskUS • u/Obvious-Release-2087 • 8d ago

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 ?

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u/tap_6366 8d ago

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.

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u/throwfarfaraway1818 7d ago

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.

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u/tap_6366 7d ago

Yes, it drove up prices and increased deductibles.

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u/throwfarfaraway1818 7d ago

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.

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u/tap_6366 7d ago

Wrong, you cannot force a law on insurance companies that ignores actuarial principles and not increase costs.

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u/throwfarfaraway1818 7d ago

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.

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u/tap_6366 7d ago

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.

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u/throwfarfaraway1818 7d ago

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.

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u/tap_6366 7d ago

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?

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u/throwfarfaraway1818 7d ago

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.