One of the arguments (for) the ACA was that most people got their insurance from their jobs, thus by allowing everyone access and do away with pre-existing conditions, then many could buy on the open market. I had no clue since I had employer based insurance for over 30 years and my late husband was self employed,...
Best answer: One of the arguments (for) the ACA was that most people got their insurance from their jobs, thus by allowing everyone access and do away with pre-existing conditions, then many could buy on the open market. I had no clue since I had employer based insurance for over 30 years and my late husband was self employed, thus on my insurance. Then got laid off, became a independent contractor, thus had to go into the open market, only to find, that my husband who had PD, that in my state (no) insurance company would insure him since he had an pre-existing condition. Our options were the high risk state pool ($100,000 lifetime limits) or short term policies (exclude pre existing conditions, but covers everything else) till he reached age 65 and on Medicare.
Now I remember years ago, and am guessing with most employer health insurance is that they covered mental health and pregnancy, the 2 things that many people complain about with the (essential coverage with the ACA) especially if male or would never need any mental health coverage. But with most employers insurance, it was subsidized at least 50%, lower deductibles, thus (unless) you had to buy a private policy, had no clue the (true) cost of your health insurance.
As to one poster who stated they wished employers would give you the options on your benefits, there (were) some out there. Back in 1988, worked for American States that was sold to Safeco. They paid everything for the employee only and you only had to pay for a spouse/children. They would list (each) option of health insurance, dental, disability and life insurance etc, and then would show how (much) the employer paid for (each). I remember they paid $6,000 (1988) for my health insurance and I thought wow that much. But say for instance you had a spouse who had health insurance, thus stayed on theirs, thus the employer would (reimburse) the amount the company paid to you (26 week paychecks, taxable) if you chose to not elect those. They were the only company that did it and not sure if they still do or not, since I left them in 1996.
The reasoning of the mandate (tax) was to force everyone to buy insurance, since we live in a society, that especially if young, think we don’t need it, or (when) a woman gets pregnant, or that I will need surgery, thus who can I buy insurance for my pregnancy, surgery and pay a few months premium for insurance to pay thousands, then drop it and buy it (only) when I will need it.
But, because they had to eliminate pre-existing conditions, and add all the essential benefits, plus did away with lifetime limits that in some cases was a max of 1 million, which sounds like a lot, till you have a 16 year old kid who gets cancer, only to need another ½ million to continue treatment.
Now the fine was suppose to get so many young/healthy into the pool, but since low/small and even if they could get a subsidy to pay for the insurance, many of them did not, thus the expectations did not happen.
So far the talk is that they will still cover pre-existing conditions, but with the tax penalty gone, then even more will choose not to buy, thus will have more sick vs healthy and the cost will most likely be higher again.
Either way, the biggest problem we have is the (cost of healthcare) which is about 3 times higher than any other country. Our premiums are based on how much insurance companies pay for claims, thus until we can lower (healthcare and drug costs), then it will continue to spiral out of control.
1 week ago