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amluto | on: Trump wins presidency for second time
> Sure there are problems with ACA

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.)

prewett | parent | next
And if you are relatively healthy and able to pay your regular doctor bills out of pocket, ACA made catastrophic insurance illegal (because of the minimum requirements). It's sort of like making car insurance require $50 copays to the mechanic. Sure, it's nice if you need an engine rebuild, but paying for all that makes the insurance a lot more expensive if you have a reliable car. There's no need for me to pay the doctor's bill and the insurance company's profit+overhead, I'd like to have the option to pay normal stuff myself and only insure something too large for me to pay.
jampekka | root | parent | next
If healthy people could opt out of insurance, it would get really expensive for the not-so-healthy. That's why mandatory insurances are quite common.

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.

nradov | root | parent
This might not be quite what you want, but the ACA does allow for High Deductible Health Plans (HDHP). Those have consumers paying out of pocket for normal stuff, using a Health Savings Account (HSA).

https://www.healthcare.gov/glossary/high-deductible-health-p...

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jjav | parent | next
> It’s really hard to be excited about the ACA.

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.

lokar | parent
Re: 2

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.