I think the 20 million comes from two main groups:
Please be careful with the 'working class' definition. It basically means hourly employees who in general work do not enough hours to be considered full time. It doesn't mean blue collar in this context.
I'm one of the 20 million, we had lots of choice of plans, but not choice of providers. We saved butt loads of money especially considering I needed surgery. We are on a co-pay plan, not a high deductible one. The high deductible plans sounded dumb, so we picked something else. Our premiums did just go up, but not by a lot.
i went from a $68 basic plan to a $268 bronze "minimum value plan" including a whopping $18 per month subsidy, which has gone up to around $350 this year and they say i get no subsidy. as a self employed healthy relatively young person, i believe we took the brunt of the shaft of making up the difference to cover previously uninsured people. mind you, the $68 plan gave me just as much(little) as the bronze plan, just for $200+ less per month. no family of four should be paying 13K per year(about what we did last year) for healthcare that doesn't come with limo service and gold plated surgical instruments. unfortunately, i believe the big winner in the whole thing was the insurance companies' bottom line.
i elected to drop coverage and put the money into an account to pay for any expenses for me. i am planning to also take some of that money and get a dental plan. the penalty for not having minimum value coverage is less than 2 months of coverage for me, and on a yearly average i see the doctor once and get one prescription(i get bronchitis every feb or march it seems). those visits were never covered under my previous plans as for the cheapest plans visits started getting covered after 3 and there were no prescription benefits until the deductible was reached.
so i count against the 20 million as of jan 1. 19,999,999 now.
In reply to patgizz:
Please still get catastrophic insurance. You are right you can self insure much more intelligently than any insurance plan. But, a few months of unplanned critical care could cost more than most Americans will make in their lives.
I know how much the ACA has put the squeeze on the self employed and the lower working class. I can only continue to count my blessings that I work for an employer who has the ability to keep the costs within reason! With that said my biweekly deduction is about $100 and my overall expenditure is about $6k out of pocket which compared to what I was paying in the dealership world ($174/wk, $11k out of pocket) I feel as though I was awarded a raise.
My anecdotal observations are the people I know who didn't have insurance before due to the expense still don't have insurance and my families insurance costs have more than quadrupled while receiving less coverage under the ACA.
I worked at a place that had pretty good insurance with a small amount coming out of myy check, My end was 110 a pay period and it was a low deductible.
That company went the way of receivership and they closed the doors.
Now Im at a company with the worst insurance offerings. The want 365 dollars per pay check for the crappiest coverage. High deductible, high copay. I wanted to find coverage like I had before but that is not possibe because the way ACA is written if your place of employment offers a policy you have to go with that. I wanted to be made part time so I was not eligible for the policy offered by my company but they will not go for it.
I am type one Diabetic and allergic to insulin and am without insurance since I never signed the papers. I cant have that much $ taken from my check and still have to pay the high fees since I have a friend who is dying from Pancreatic Cancer that I am supporting so I am stuck for now.
This is what Im dealing with right now, I tried to get in a drug trial but was denied since I have no insurance.
Lost my insurance last year...the plan I 'liked' and wanted to keep. Got the letter like a bunch of people in my situation (self employed).
New options are 3x as much premiums for a higher deductible...so spend 20k a year before I can use it?...no thanks.
I'm paying the penalty and have 'temporary insurance' which is high deductible but non conforming...will probably go with one of the religious cost sharing deals soon depending on what happens.
In reply to MulletTruck:
Dude, you need to get that under control yesterday. Future you might want to use those eyes and toes.
carguy123 wrote:alfadriver wrote:No it hadn't. It was an instantaneous event once we went ACAcarguy123 wrote: Your cost has gone up astronomically and your choice of doctors shrunk just as astronomically as well as your choice of insurance companies because most of the big companies have been pulling out.All of that happened even before the ACA, so I'm not sure how you blame that. When I started work, we had a huge choice of who to be insured by, and the set of doctors. Over time, that reduced to 2 traditional plans and a single HMO, with the cost going up every time.
That effect may have something to do with your state. I didn't see it in any of the states I lived in, but I do understand that due to the crazy structure required and the opting in and out and all that nonsense; states could have different implementations and different effects.
Things have to get worse before they get better. Change needed to happeN. In 2009 I Had a girl in a big city hospital, it cost me $1200 out of pocket. I had a son in 2011, with less complications, in a big city hospital It cost me $6800 out of pocket. So, three years and nearly 500% increase in costs pre ACA.
I spent most of my childhood without medical insurance. Which would have been ok, had I been heathy. Two eye surgeries and constant treatment of my asthma really put a strain on my parents. I don't want to see anyone have to go through that.
KyAllroad wrote: In reply to MulletTruck: Dude, you need to get that under control yesterday. Future you might want to use those eyes and toes.
When my friend passes away I will be able to jump back on it but as of now Im screwed.
They have been wanting to take my legs from the knees down for a couple years now, That is why I am putting an Automatic in my truck and not replacing my wore out Motorcycle.
Its a timing thing.
I appreciate all of you keeping it (mostly) civil. It does, however, appear that absolutely none of us know anything at all about this.
I think there is only 1 person who attempted to answer my question:
bastomatic wrote: But back to the OP, here's some numbers. During 1Q 2016, 8.6% of Americans lacked health insurance. In 1Q 2008, that same number was 14.6%. That's a drop of 6 percentage points. The population of America is 319 million, 6 percent of which is... 19.14 million.
Unfortunately, he missed too. That is a national total statistic. It does not address how many people dropped "real" insurance, and how many people were added to the rolls of Medicaid.
I submit that including Medicaid in the insurance numbers is a political shell game. Medicaid is not insurance. It is a governmental benefit for people who cannot afford insurance.
So, looking at those numbers, there is no indication if 1Q 2008 figures included Medicaid. There is also no indication of how many people lost coverage they previously had. In my own case (yes, anecdotal), 80% of the people in my household who were previously covered prior to ACA no longer have coverage of any kind (we can no longer afford to buy it, make too much for subsidies, and don't qualify for Medicaid).
I know the decisions I have to make. I have no choice but to consider the faith based options (unless I were to divorce my wife, which would greatly improve our access to insurance and other medical benefits). But that doesn't address my core concern. If the system is actually an improvement, I will support it even if I am an unfortunate victim of it. However, if the system is a political shell game that is actually nothing more than a vote grab, I can not support it.
Unfortunately I still have no facts. My perception is that the "losers" in the process are middle class and often self employed (who often lean toward one political bent), and the "winners" are poor and younger, who often lean toward the opposite political extreme. It looks like the purpose was not to get more people medical care or medical insurance, but rather to get more people receiving Medicaid benefits, which could potentially influence people at the polls.
...and yes, it is clear to me(as others have noted) that this will end with single payer. At this point, I say bring it on. It would be a clear improvement. 
Perhaps... Probably... the question is how. The way things are set up now, the transition to a single payer system is likely to be very messy. A lot of players with a lot of money will fight it every step of the way.
SVreX wrote: ...and yes, it is clear to me(as others have noted) that this will end with single payer. At this point, I say bring it on. It would be a clear improvement.
Think about this, then think about ACA.
My thoughts are this is why it passed. Break the system bad enough, and they can get anything passed.
SVreX wrote: ...and yes, it is clear to me(as others have noted) that this will end with single payer. At this point, I say bring it on. It would be a clear improvement.
Getting rid of the middle man who's #1 goal is to make money isn't a bad thing.
Keep the money with the people who actually provide service.
Also, there was an interesting small article on NPR this morning, mentioning about the great advancements Cuba has made with cancer treatments- and ALL of their funding is from a communist government. These are things that our hospitals are really trying to get. For whatever reason, our model of healthcare didn't find them. Kind of illustrates that our model of health care development may not be the best one out there. Again.
In reply to alfadriver:
Well, our model of healthcare is "for profit", which like it or not tends to conform to the capitalist principles upon which this country was arguably founded on - at least that is essentially the argument against a single-payer system. As mentioned, being profit driven, our system benefits more from "treating" patients rather than "curing" them. A "cured" patient doesn't really use the system, now do they?
And again - those middle men have a lot of money at stake and will not step aside quietly.
In reply to alfadriver:
I agree with you in theory. In practice it's not always so simple.
Removing the middle man always sounds like a good idea, but sometimes not so much.
As a contractor, my work is primarily a "middle man". I provide knowledge and efficiency, and I expect payment for my services. Yes, owners can often choose to eliminate me and do the job themselves. However, I have seen a LONG history of botched projects performed by owners who didn't think my services had value.
Single payer may work well, if the payer is trustworthy and competent. We are, unfortunately, talking about our government. Their status as Benevolent Dictator has not always been proven. Success remains to be seen.
Calling medicaid "not insurance" isn't quite fair. To the people who have it and go to the doctor it certainly works like insurance. It's a single payer system. A LOT of Americans we already on single payer care. Older Americans, Veterans, and the "poor" all benefit from a single payer system that does fairly well all things considered. The only Americans that can't opt into the single payer systems are largely those that provide the funds for those that are covered by it. So I can pay taxes that provide single payer insurance for about half of the country (a quick Google of Medicare and Medicaid Numbers) but I can't participate in any single payer system myself. I have to get it through work or pay myself.
Edit: more like 1/3 of Americans on single payer. Better googling provides better answers.
Ian F wrote: the capitalist principles upon which this country was arguably founded on
It's a bit of a sidetrack, but I don't think our country was founded on capitalist principles. The founding documents say nothing about capitalism. They say a lot about liberty, freedom, and equality.
In reply to mazdeuce: Just FYI. Not all veterans, while any veteran may use VA facilities, there are income or disability benchmarks that must be met or we pay for services just like everyone else.
In reply to dculberson:
Well... that is a separate discussion. But in essence, there is what was written in the history books to rally the masses and give the general public warm, fuzzy feelings, and there's what was told to the people who moved the money around to make the revolution happen.
In many ways, not much has changed in 250 years. The venue and the players maybe, but the game is still the same.
Robbie wrote: I think the 20 million comes from two main groups: 1. People who work hourly and do not generally get coverage from their employers (the 'working class') 2. People with pre-existing conditions that prevented them from obtaining any health insurance at all on the open market Please be careful with the 'working class' definition. It basically means hourly employees who in general work do not enough hours to be considered full time. It doesn't mean blue collar in this context.
Also people who are self employed or work for businesses too small to be required to provide some sort of health plan. I'm in the later group. With the ACA and the insurance marketplace, I decided it was time to purchase health insurance. I'm in good health and am one of the people paying in significantly more than I use, but it's a safety net in case I get a serious injury on the job or in one of my hobbies.
SVreX wrote: ...and yes, it is clear to me(as others have noted) that this will end with single payer. At this point, I say bring it on. It would be a clear improvement.
But only in the sense that I also think "bring on autonomous self-driving cars" would be an improvement. It's not the best situation, but it's probably the best way out of this crappy point-of-no-return we have engineered / voted / bumbled ourselves past.
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