Before the ACA those that paid for insurance were forced to shoulder the cost of those that didn't. Now, those who think they don't want to pay for health insurance are forced to pay one way or another (though I think the penalty is too small).
I find it hard to feel bad for people that don't want to pay for their own health risk or who think they don't have any.
I still believe a more open market would be a "better" solution, with a tight safety net to maintain standards across economic levels, but as that is unlikely, fixing the glaring issues with the ACA seems like a good starting point.
There is no reason we can't pursue both simultaneously. Nothing in the ACA prevents posting of price lists or incentivizing patients with cash payouts for finding cheaper than average care.
That is what has driven me crazy about politics -- it is more about making noise about the other side than actually doing something that might push things forward. Republicans could have pushed open market reforms the moment ACA was passed. If they did it on a state by state level they could even point to data of success vs pure ACA states to bolster their agenda.
Not anymore. The new tax law removed the individual mandate.
Trump seems to think it will lead to the ACA falling apart. He might be right but only as part of the entire current insurance system falling apart around it. I really don't know what the intention was, there. As simple as fulfilling a campaign promise no matter the cost?
When a lot of people don't want the policy at all it becomes a cost forcing scheme though...and that's the crux of the problem.
If this was California legislation and it had problems, local politicians in California would be campaigning to make the changes right now. The question of how long we're going to be stuck with the current issues is where the federal flaw lies. It removes the ability of people to adapt and react to problems. The larger pool is a negative when the pool size expands the scope of issues.