How did this little gem sneak into the ACA? It seems like it was put in by somebody who doesn't understand game theory.
Healthcare in America is terminally ill. In it's current form, commercial insurance, like Aetna in this article, are rewarded for pumping up the total cost of care as big as possible while keeping their members just healthy enough to dump off at the doorstep of medicaid when they're old enough to qualify for it.
It didn't sneak in.
The issue was that before the ACA we had insurers that were below 60%.
They managed this by cutting people off of healthcare once they started using it aka recission panels.
The problem is that the ACA is a working solution and was meant to be updated once we got real data as to how things were or were not working. Of course, that was before Republican intransigence.
Personally, I'm glad for Republican intransigence. We're going to get to single payer long before I ever expected to.
I think you're right, but I think it will take a pair of full pendulum swings:
1. The GOP gets its way, and trashes the ACA more than it already has.
Followed by:
2. A huge backlash, including "middle America" who finally realize they shouldn't vote for the people most interested in cutting the programs they actually depend on.
I just worry the gap in time between #1 and #2 will be drawn-out, painful and; to some; deadly.
The GOP (barely) failed to hack up the ACA this Congressional term, and I would be shocked if they came out of the midterms in the same or better shape than they're in right now.
More shocked than when Trump won in 2016?
Either Obama and the Democrat super majority of 2010 were complete idiots when they wrote the ACA or they fleeced the American people with a false bill of goods. Note that “or” is meant to be interpreted as the Boolean algebra definition.
It certainly doesn't help that the GOP systematically blocks any attempt to reduce the influence of private industry in health care. Medicare manages to control costs, but a Medicare-for-all proposal never had a chance of making it through congress because it needed GOP votes to pass.
If one party consists of "complete idiots", the other consists of corporate lackeys and paid shills.
a Medicare-for-all proposal never had a chance of making it through congress because it needed GOP votes to pass.
"the Democrat-controlled House and Senate committees adopted nearly 190 Republican amendments while writing the legislation, according to data compiled by The New York Times."
Source: https://www.nytimes.com/interactive/2017/07/21/us/health-car...
To this day, NYT will not acknowledge how phony their financial assessments are with respect to the billions of losses via just the Risk Corridors and community centers. There was more than a $5.3 billion deficit in Risk Corridor spending for 2015 alone[0]. Enrollment was overestimated by the CBO by over 100% even while Obama was still in office[1]. And the numbers are still in flux as insurers who didn't get all the bailouts they were "promised" successfully sue for hundreds of millions[2].
[0] http://www.modernhealthcare.com/article/20161205/NEWS/161129...
[1] http://thehill.com/blogs/congress-blog/healthcare/309902-oba...
[2] https://ecf.cofc.uscourts.gov/cgi-bin/show_public_doc?2016cv...
What crocodile tears! Democrats bent over backwards to convince moderate Republicans to support the bill, and adopted many changes in committee. No GOP senators were going to be caught dead actually voting for an amendment on the floor, so they made their changes in private. Plus, Scott Brown's election meant that the law couldn't be amended or reconciled anyway.
But this has nothing to do with Medicare-for-all: it was killed because Joe Lieberman refused to vote for any bill containing such a provision. So if even one GOP senator had supported the idea, we'd all have access to Medicare. I made a factually true statement.
It seems safe to say that, even at the time, the number of insurers was nowhere near sufficient (in any given geographic area). That number is even lower today, something feared by the law's critics.
There are some other shaky assumptions built in, as well, including the one that price alone is enough to win more business, even assuming identical/equivalent networks (another shaky assumption). A reputation for terrible claims practices might be enough to dissuade someone from saving that extra $3/month in premiums.