I will start by acknowledging that I, like most others, have not read the voluminous pages of The Affordable Care Act. I can say, however, that since I am a psychologist and have been a high utilizer of medical services over the course of my life, I know a thing or two about health insurance. This includes having a full grasp of the difference between HMO’s, PPO’S and now PPO Choice, which was formerly called Point of Service (POS) – PPO in name but HMO in disguise. I also probably have better grasp of deductibles, co-pays, coinsurance and stop-gap (out of pocket maximums) than the average insured.
The Affordable care act as I understand it has 2 major goals: increasing the number of insured people (the mandate) and insuring that certain facets of health care are covered in every policy. The ACA is not an insurance plan nor does it dictate any “new” types of specific coverage that were not already covered by the best comprehensive plans before the act. The ACA is not responsible for the plans offered by insurance companies nor the ultimate pricing of those policies. What the ACA does is address the terrible problem of poor people, people out of work and people who have any number of ever increasing conditions which render them "uninsurable" from being without insurance. It also prevents people from paying for sham insurance policies that end up providing unreasonable, if any, coverage at all.
To blame the ACA, or Obama-Care as most detractors are quick to label it, for the bulk of pricing increases, whether in premium, copay, deductible, etc. is like blaming the school that initiates a dress code of blue or black pants and white shirts, and the only store in town quickly raises the cost of those items 25 percent. From an actuarial standpoint, the larger the pool of insured members, the most cost effective insurance should be. But, of course, insurance companies would not profit in the manner that they are accustomed to, and thus although more people will be insured, keeping the pools of small businesses and large businesses separate and keeping those pools separate from individuals is in their financial interest – the ACA doesn’t dictate that.
