That’s the plain language interpretation of this: Why hasn’t the US been trying to fix its health insurance problems? | CNN Politics
About half the country already gets its health coverage from the government:
38+% are on Medicare or Medicaid
Then, add in those on VA benefits, Indian Health Services and other government programs, plus about 22 million Federal, state and local government employees AND their families – and half the country is on a government health plan.
Of the remaining, about 6% are in the ACA individual marketplaces – and this is the group protected by the ACA’s pre-existing conditions prohibition. But even the ACA has a pre-existing condition waiting period – if you are not insured on January 1st, you cannot enroll until the next year. That is effectively pre-existing condition waiting period.
Further, those on group insurance policies (employer plans) were protected by the HIPPA act of 1996. That act, however, did not protect the individual market – although about half the states enacted some form of pre-existing condition protections. In other words, the sales pitch of pre-existing condition coverage made during the ACA sales pitch was bull shit – almost everyone except for part of the individual market, already had protections. The politicians lied to you – what a surprise.
Those with group plans are subsidized by tax breaks that were prohibited, by the ACA, to individual enrollees:
Here, the government only provides health care for the neediest, through Medicaid, and older Americans, who generally qualify for government-run health coverage in Medicare. Thanks to Obamacare, the government also subsidizes care for those up to certain income levels who don’t get coverage from their employer. The government also subsidizes employer-provided health care in the form of tax breaks.
The above is slightly misleading – the ACA provided a sliding scale subsidy to 50% of the individual market enrollees. Later, Congress added an additional subsidy taking that to 80% of the individual market, after realizing most everyone in the ACA individual market had premiums higher than what the ACA itself defined as “unaffordable”. Specifically, the ACA said if premiums were greater than 8.5% of household income, insurance was unaffordable. Soon after the ACA took effect, most individual purchasers found the premiums were much more than this level.
62% of Americans support the ACA – but that’s because most everyone is on a group plan or a government plan – and not in the individual market where premiums are sky high. How high? Last year, my wife and I paid about $2,000 per month for an ACA “Bronze plan” (cheaper plans), with a annual family deductible (for 2 people) of $19,200 per year.
I just checked 2025 Bronze plans, and they would have cost $2000 to $2400/month for an unsubsidized plan.
By the government’s definition of the 8.5% cutoff, if you make less than $280,000 a year, the annual premiums exceed the threshold!
