ACA Update

Reader R wrote in with his Obamacare story, and that reminded me that I forgot to share mine. R’s gripe was that doing his taxes was a lot more complex, and he had a task figuring out how to file with the new (to him) form that was added to his normal tax workload.

When I became a Colorado resident, I decided to try using an insurance agent instead of doing it myself. This made things go a little better. Also, with the exact same income estimate as I had in New York, Colorado decided that they would give me $800 or so of tax credit in advance, i.e., they’d knock it off my premium payment. In New York, I had to file taxes to get that money back. I’m sure if I tried I could understand it better, but frankly, I don’t want to waste time figuring it out.

Because my wife and I are healthy, we have a bronze policy that has something like a $14K total deductible and $8K deductible each, which means that all of our medical care for the next year will be out-of-pocket, except for physicals, which won’t be free since lab work isn’t covered.

Ten plus years after the passage of Obamacare, politically, the Democrats have derived little or no value from it.

• Medicaid expansion is a good thing. But, politically, it’s not credited to Democrats in red state, since those states were petulant asses about the whole thing, and drug it out so that it’s crystal unclear to recipients why and how their Medicaid works.

• People who can afford ACA care (like me and R) use it like bankruptcy insurance. I can afford a $14K hit out-of-pocket. I just want to avoid a million dollar hit. This is not an inspirational story for anyone.

• Many, many young people aren’t on the ACA. Why would they? Why not take a chance at medical bankruptcy instead of paying something for a terrible bronze plan? Kat Abughazaleh, for example, said in an interview that she doesn’t have insurance.

• Insurance companies still routinely deny coverage and do shitty things.

I look back at the Obama years as the last chance that Democrats had to do something really ambitious, and we failed. The promise was a major reform of the healthcare system. The result was Medicaid expansion, and crappy insurance that you can buy if you don’t have another alternative.

Tim Walz’ observation that benefits should be universal must be internalized by the Democratic Party. Republican moms in Minnesota suburbs love free school lunch. The next time Democrats take a run at healthcare, if it isn’t universal, we shouldn’t even bother. There will be plenty of other things to do if the country is still governable in 2028.