Second year we had another option in our county which was about 15% higher than BCBS (which had gone up about 25% from the year before).

Apparently some/much of this has to do with our state choosing to opt out of dealing with increased medicaid funding, so... yay... I guess they get to show obama how bad ACA is by... digging in their heels while we all just pay insanely increasing pricing?

We are > 100% from where we were wrt premiums from 2012. I expect some increase every year. I don't expect > 100%.

Colleague of mine is now facing > $1800/month health insurance pricing. He's... early 50s, married, 3 kids. This is with a $10k deductible. Another colleague with just one spouse and a child was facing going from $1300->$1650 this year, again with a fairly hefty deductible.

Given that this is effectively only something you'll get any benefit from if you're in a horrific accident of have a massive illness, this is now just really expensive catastrophic insurance.

I might feel slightly better about some of this if I actually knew anyone personally (beyond Frondo now!) who's benefitted. In my social circles, this has not even been close to a win for anyone. Either insurance has gone way up for people who can afford it, or it's still too expensive for some of my friends who are still unable to afford it (because they don't make enough money to qualify for the 'subsidized' pricing).

Bring on single payer...

ACA has absolutely been a net positive in my life. I had cancer in 2012 and so it would have been literally impossible for me to get health insurance outside of a group plan. With ACA I've been able to go independent, start my own business, choose my own clients, and fully control my destiny.

Essentially, pre-existing condition insurability is where the government could have make a huge impact with minimal disruption to the overall system. Much like there are government mortgage guarantees available for higher risk borrowers, the same kind of system could have helped the pre-existing conditions people get coverage while not throwing the baby out with the bath water.

The alleged goals of the ACA were to get everyone insured. However it shouldn't have taken thousands of pages to accomplish that. A good portion of ACA has nothing to do with insurance at all.

I wish there was some scope restriction on bills. For example the latest highway bill contained passport revocation provisions for those with delinquent taxes. This forces politicians to reluctantly vote for something they don't like because the overall bill is important. Poison pill amendments are often not poisonous enough so we get stuck with a bunch of really bad laws.

My own view is "getting insured" shouldn't really have been the goal, at least not with the current 'insurance' system in place. The goal should be making sure people have access to care/service, not access to purchase insurance. I have insurance, I'd be hard pressed to use it outside of a catastrophic event, because I have such a high deductible. Headaches with blurred vision... I may eventually go, but... I don't really want to be on the hook for $10k+ in bills just to find out "oh, it's nothing, get some rest".

Expanding medicaid would have ensured that more people would have had more direct access to care with minimal disruption to everything else.

That's because your state is run by people who want desperately for the ACA to fail, and so they are intentionally making it as crappy as they can.

The more surprising part was our Republican Governor was the one that advocated for it and pushed it through the party line (with a lot of grumbling). His argument was it would save the state quite a bit of money and so far I believe it has.

Let's be fair here. The ACA said that the feds would match the expanded medicaid enrollment for a few years, but after that the states would need to continue to sustain the larger enrollment on their own. Medicaid is a significant chunk of state budgets, and doing that meant raising taxes, or lowering expenses in other areas, or taking on debt.

It's not as simple as "screw obama, and screw poor people we ain't doing it." In the post-crash years, while money was scarce, there was some real concern over where the money would come from, how much it would need to cost, and how states would cope.

Well, the increased Medicaid funding is temporary, but comes with permanently higher Medicaid spending. So a state might reasonably not want to accept that offer.

To clarify, these variations have historically averaged around 60%, and likely will continue to (sans ACA expansion): http://kff.org/medicaid/state-indicator/federalstate-share-o...

Something needs to happen with USPTO, especially medicine at this point.

The patent system is essential for medicines. I know many people don't like that reality but who will invest in pharma companies if their investment could quickly be nullified due to the loss of intellectual property? Would you invest in a company when the competitive advantage that company is immediately rendered moot?

However, there are definitely places for reform, so I am not fully defending the USPTO system, I am simply suggesting that a strong patent system is a fundamental motivator of pharmaceutical innovation.

I am not suggesting that patents go away entirely, but their scope should definitely be reduced... extension patents in particular should not receive the same 20 years that original patents receive. The patent system has resulted in generations of gaming the system to the point where it no longer works.

I'm unconvinced that patents serve the public good in this day and age. I am convinced, however, that the vast majority of patents granted should not have been.

In my opinion, the problem was never the unavailability of insurance. The problem was (and still is) the out-of-control pricing of medical care -- $5000+ for non-sterile gloves [1] is a bit extreme.

[1]: http://www.rd.com/health/wellness/wildly-overinflated-hospit...

I would suspect that more free primary care clinics could take some of the burden off of emergency rooms in terms of cost and those free clinics could even be funded by insurance companies from the money their saving from not having to pay for $5000 gloves anymore.

A cash-payment medical system would also solve some of these problems. With opaque pricing, hospitals get away with solving budget issues by overcharging. If you actually saw the menu of what things would cost and you were paying out of your pocket, nobody would ever tolerate $5000 gloves. Market forces would fix the cost overages very quickly. As it is now, very few people actually directly pay for their own care and thus are less motivated to care about price. "Insurance covers it," is all many people care about.

You are in the minority.

Every insurance company that provides Obamacare in Oregon is increasing rates for the average customer this year.

http://www.oregonlive.com/health/index.ssf/2015/07/more_than...

In fact, the State of Oregon has actually ordered some of the companies to increase their rates more than they'd originally planned.

http://www.cnbc.com/2015/06/22/oregon-dumps-cold-water-on-lo...

The description given matched my experience with insurers before ACA. My problem with ACA is Healthcare.gov (still). It is possible to go through the entire application process, make one mistake or fail to provide the right detail, and end up disqualified from buying insurance through Healthcare.gov (in my case, I used a mail forwarding service address, because I travel full-time). There is no do-over, no online process for correcting the problem with the application. You have to go through a protest process that involves mailing physical letters somewhere. Fuck that. I'd go back to the nightmare that is pre-ACA private insurance, before I beg some bureaucrat, by mail, for the privilege of paying too much for insurance.

Healthcare.gov got a lot of flack in the beginning for costing too much, delivering too little, and being too flakey. All of those things are still true. It's also dehumanizing.

I moved back to Oregon from California several years ago. I was astonished at how much more expensive insurance was in OR than in CA.

I've been told that Oregon has had a lot of protectionism for local health insurers, so they didn't have to compete much. So perhaps you're just seeing Oregon coming into line with other states...

(By the way, I had a pinched nerve in my neck when I moved. No insurer would take me, and one told me that they wouldn't insure me until nine years had passed without any symptoms)

If the ACA had merely fixed that, then your premiums would be going down more and you'd be getting better insurance.

Telling me it's "regulations" that had every insurer reject me? Pull the other one, it's got bells on.

Sorry - it wasn't quite the same as not being able to get insurance at all. Didn't mean I couldn't get insurance at all, but was 'rated' fairly higher than what was originally quoted.

I didn't know about this, but it changes quite a bit regarding pre-existing conditions. Could you please point me to a citation or something about this?