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Comment by dboreham | Hacker News Reader

There are a couple of forces at work: 1. Medical folks charge more over time, for...reasons. 2. Previously insurance could be sold tailored to the customer's ability to pay; but that insurance didn't actually cover many useful things and had a low cap (hence was almost worthless). ACA disallowed that and made insurance industry offer policies that cover the stuff a regular person needs covered.

So you could have the impression that you had "cheap insurance" as long as you never need to have significant healthcare paid for.

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I made significant use of my healthcare pre-ACA ($30k-$50k charges before insurance). All of it was in-network, covered, and a small annual premium.

The very year ACA took effect my health plan was canceled, my doctor went off-network, my new plan had 3x the annual premium and has grown 30% year over year, as have deductibles, and I fight tooth and nail every single charge to make sure it is in network and covered.

Yes, one anecdote is not data. But there is no more validity to the politician's lie that I can "keep my health plan, keep my doctor, and health care costs will go down."

"The very year ACA took effect my health plan was canceled, my doctor went off-network, my new plan had 3x the annual premium and has grown 30% year over year, and I fight tooth and nail every single charge to make sure it is in network and covered."

Same here, and I hear the same exact story from most people I talk to. Plans dropped, premiums skyrocketing. Here in Phoenix we've got a single insurer left, and we'll see if we have anybody next year.

What I haven't seen is stories of average joes who were substantially helped by ACA. Sure, if you didn't have coverage before by cost or pre-existing condition, or get subsidies now, maybe you're happier. But the vast middle class, not so much.

Post ACA I'm able to get my wife insured (congenital heart issue fixed forever at 14, still used to deny her coverage at 27), and my premiums dropped. We're rather firmly middle class, pretty sure I didn't qualify for any health subsidies, I think student loan deduction and mortgage were it.

So there's a face for you, 32 year old, healthy, middle class, white woman who likes cats, rides horses, and has a pet bearded dragon who she talks to in a baby voice can get regular cancer screenings because of ACA.

Healthy was the key word there.

Average joe here: pre-ACA, I was uninsurable. My pre-existing condition was having had an organ removed in my 20s. No one would insure me when I went to buy it.

Post-ACA, I could once again buy health insurance.

I consider no longer being locked out of the US medical system a substantial help.

My partner is middle-class and was able to pursue education and a career more freely because she could remain on parent's isurance until age 26. By the time she hit 26, she was on her employer's insurance.

Consider also the not middle-class recipients of medicaid expansion.

Individual, or group plan?

In Florida, Blue Cross Blue Sheild had a plan called Go Blue pre ACA/Obamacare, it was a kind of bare minimum coverage but monthly premiums were like $80 and BCBS of Florida carries one of the best reputations and has one of the largest networks of providers.

Something like 80,000 Floridans lost that policy because it didn't carry the minimum services under ACA/Obamacare. But it wasn't just losing the policy, they were never able to afford the new blue cross blue sheild policies, having to purchase from a new insurer most of whom had reputations as fly by night operations (many not existing before ACA and shutting down 1 and 2 years in), and finally losing the good BCBS network.

Here is a copy of the actual letter sent out by BCBS when they had to cancel the policy: https://www.floridablue.com/blog/my-policy-being-canceled-no...

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