Was it? From a foreign perspective it doesn't seem to have changed the conversation around US healthcare at all.
This was huge because if you ever lost insurance and got new insurance (switched jobs) then you were often screwed.
ACA defined essential benefits. Before ACA insurance usually didn't cover things mental healthcare. Required coverage of preventative care/screenings/reproductive care for women.
Annual and lifetime coverage limits were banned. Your health insurance could no longer drop you because you got an expensive to treat cancer.
The amount of desperately needed consumer protections ACA added were immense.
Sure there are problems with ACA, especially the marketplace part of it, but overall it was a big change to healthcare in the US.
That’s putting it mildly. Sure, the ACA was, in many respects, a big improvement over what came before it. But it’s still outrageously broken. Let’s consider the perspective of a person who wants health insurance:
1. You mostly want to be insured via your employer, and you mostly get screwed if you leave your job. The financial disincentives to insuring yourself are huge unless you qualify for the subsidies.
2. For some bizarre reason, you can use only buy insurance at some times of the year.
3. You more or less have to buy insurance through a website that is massively and incomprehensibly bad. Want to figure out what that insurance covers? It’s sort of doable, but it sure isn’t easy.
4. Whether or not you will get to fill a given prescription still seems arbitrary and vaguely malicious.
5. The whole system rubs the insane list prices of healthcare in your face, almost continuously. For drugs, even small amounts of Internet searching points out how much cheaper they are basically anywhere else.
It’s really hard to be excited about the ACA.
(For added fun, and this isn’t really the ACA’s fault but it sure is a failure of affordability and sure seems like a massive failure of government: check out hims.com. Pulling a random example, “generic for Cialis” is at least 3x the price on hims.com as it is via GoodRx.)
While your complains are all true and the ACA is a mess compared to any developed country, it is still very exciting to have the ACA. For anyone who was barred from getting insurance before, it is the lifesaver, literally.
Compared to other countries, ACA isn't very good (to put it mildly) but compared to how the US was before it, it is the most wonderful improvement ever.
Wheter it's a good idea to do this via private for-profit insurance and healthcare is another question. I prefer to just pay it via taxes.
https://www.healthcare.gov/glossary/high-deductible-health-p...
I’m not saying that the ACA was a bad law. I’m saying that a not-so-nerdy voter contemplating whether ACA is a great achievement of the Democratic Party is likely to be unimpressed.
You can use a broker (free to you) and get the same (regulated) plans. If your situation is at all complicated you should definitely use one. Probably even for “simple “ cases.
To give you some context: every country is different here but usually we have an almost free healthcare system covering everything for everybody (but sometimes you have to wait for a long time) and private healthcare that is more expensive, usually faster but not necessarily better.
Here in the UK my wife and I have between us spent a fair bit on private medical care over the last year - in the case of my wife for cataract operation on both eyes and in my case dental implants and related procedures.
What I find amusing about private health care in the UK is that in each case I have ever used it they make it clear that if something goes seriously wrong they will take you to an NHS hospital.
Privatize the winnings, socialize the losses, the "free market" working as intended.
The part where we don't have the free healthcare system is mostly due to politicians being afraid of socialism or being afraid of raising taxes or both and a very strong medical lobby that doesn't want the salaries of doctors (very high over here) to drop.