The ACA Still Sucks and Walz Knows It

Those of you unfortunate enough to read me regularly know that I’m a part-time worker, and when my wife went part-time, we went from her excellent work health plan to a bronze plan on the exchange. So I’m going to start with my latest complaint, and then turn to Walz.

I just moved to Colorado from New York. Since my residency became active this month, I had to sign up for the ACA here via the Colorado exchange. That went pretty well, but when it came time to cancel my insurance on the New York exchange, the auto cancel on the exchange would only cancel through March 31, not today. That meant double premium payments (Colorado and New York), so I called my insurance carrier. After being transferred, I was informed that they couldn’t do anything, that I had to go through the exchange. Three more calls later, including one where the agent clearly didn’t understand anything and basically hung up on me, I have some form of appeal in that will maybe let me get out of paying for March in New York.

All of this for insurance that costs me a lot of money ($1300/mo) and basically has no coverage until sky-high deductibles are met. It’s medical bankruptcy insurance that lets me buy off of the insurance company’s contract.

Putting the insurance company into the middle of this mess was a policy-wonk-brain decision that I fully understand given the politics of the time, but I believe that Democrats derive far less political benefit from it that what we’re told. I think that Democrats need to start being honest about the ACA for middle-class folks who have no other insurance options: it sucks, and we want to change it.

In a world with a ton of remote work and gig labor, the number of contract employees is rising every day. These people are lower-middle-class or middle-class, and insurance for them is a nightmare. Why the hell would someone making, say, $80K/yr, want to pay for a do-nothing insurance policy even with premium support that takes it down to, say, $250/month. That’s a lot of money!

I realize the world is on fire and my bitching about the ACA may seem pointless. But the more I think about it, I’m interested in how Democrats can change, drastically, to win this country back. And at least one Democrat, Tim Walz, is thinking that way:

Here’s the whole interview on YouTube — I haven’t listened to it yet but I’m sure I’ll have more to say about it. Walz is a real talent, he was clearly muzzled at the debate, and we need to hear him unfiltered.

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Tam R1 year ago

I have held off on commenting on this post because I fully admit to getting defensive when I see headlines like the ACA still sucks. I devoted soooooo much time and energy to its passage. The Rockefeller Institute published a book about the fight to pass it and I was interviewed in that book. I say that only because my involvement wasn’t just attending some rallies. I was in the room where it happened so to speak. I have a lot of thoughts and maybe even a few insights but it’s involved and doesn’t lend itself to a quick comment. If you ever want to talk about it I could probably muster the bandwidth for that!

mister mixAuthor1 year ago

If you want to do a guest post with your POV, anytime, my email is [email protected] or [email protected] .

Tam R1 year ago

Oh thanks - might be good to get it all out!

C P1 year ago

"Putting the insurance company into the middle of this mess was a policy-wonk-brain decision that I fully understand given the politics of the time, but I believe that Democrats derive far less political benefit from it that what we’re told."

The point of it was supposed to be that roping in the insurance companies would make them invested in its survival and therefore lead them to lean on centrist politicians to make them keep it. Hard to say whether that worked or not, partly because it's hard to tell "a few centrists supported the ACA because their paymasters asked them to" from "a few centrists supported the ACA out of pure status quo bias and risk aversion," being that it's pretty much the same politicians who respond to both incentives.

r po1 year ago

The ACA was designed to be enshittified from the get go. Then John Roberts got clever and figured out a way to make it even worse. Thanks JR! I'm really feeling it dealing with multiple payments to Aetna Silver here in the GA rebranded exchange. Then I get to join your party in April, MM, when we move to AZ.

mister mixAuthor1 year ago

I'm going to try to be fair to Democrats and say that what many of them really cared about was Medicaid expansion. What the insurance company cares about is selling group plans to businesses, etc. So I, and it sounds like you, are in the crack between those two things, where there's a marketplace, you can buy insurance, and it's slightly less terrible than what it would be if insurers had their druthers.

Betty Cracker1 year ago

During the Obamacare debates, one of the frequently cited obstacles to going bigger was that most people liked their employer-sponsored coverage. Is that still broadly true? I don’t know.

I do know the market has changed significantly in the intervening years. Lots of folks with employer-sponsored coverage are paying a greater share of the cost, and many are on high-deductible plans (which you accurately describe as medical bankruptcy insurance) just so they can afford coverage at all. It sucks.

I like Walz a lot. It’s too early to think about 2028, but we need someone who understands the scale of what we’re up against and who is capable of speaking plainly. Walz checks both boxes.

John S.1 year ago

Walz needs to stop listening to the political consultants. His greatest strength is his authenticity and moral clarity. Once you obscure that with political doublespeak, you take away what makes him unique and turn him into just another creature of the DC establishment.

mister mixAuthor1 year ago

I think one thing that's changed is a lot of people are on high deductible health plans via employers. These are not a lot better than bronze plans. My former neighbor and I would have discussions about him planning his HSA contributions to take care of health expenses for his family. He worked for a big corp that was acquired by private equity. The first thing they do is cut benefits. Also way more gig workers now. That basically didn't exist in 2008-10.

C P1 year ago

"During the Obamacare debates, one of the frequently cited obstacles to going bigger was that most people liked their employer-sponsored coverage. Is that still broadly true? I don’t know."

Did most people ever actually like their employer-sponsored coverage, or was it just your basic risk-aversion of "well, it's what I have, and I'm terrified that the next thing might be different, and changing it would be such a hassle?" Always thought it was the latter, no matter what people tell the pollster.

Always thought another significant factor was that they literally can't imagine health care being better than the status quo. If I described my experience getting health care in Greece, most Americans would think I was just lying.

Sepideh M1 year ago

I think most people did not like their healthcare plans, but there were some people pointing to some nice plans that some unionized workers had as what could possibly be taken away, so if someone goes to look into this definitely talk to the unionized workers.

Kay W.1 year ago

Democrats still have a huge advantage on public trust with healthcare. Maybe it is time to reopen the issue.

Sepideh M1 year ago

Agreed.

There was a lot of explaining how things that felt bad were actually great going on the last election cycle.

The discussion of the economy was condescending and did not acknowledge that the increased cost of groceries felt bad. The discussion of ACA does not acknowledge that paying a lot for an insurance that doesn't do much of anything as pharmacy benefits managers figure out ways to charge ever rising amounts for medicine that has existed for many years.

mister mixAuthor1 year ago

For sure. It's no coincidence that the people who catch fire in the party are folks who can speak the truth clearly. We need to fire all the messaging people who tell these people to push out 30 seconds of gobbledygook versus 10 seconds of clear, communication. People know bullshit when they smell it.

John S.1 year ago

It shouldn’t be so hard to tell people that the oligarchs are screwing them. I’m not a huge Bernie fan, but at least he’s keeping that message clear and simple as he tours the country: Fighting Oligarchy*. Pick a simple message, stick to it and repeat it a million times.

Instead, you see clips of Democrats trying out all sorts of different attack lines, riffing on clever new meanings for DOGE, and struggling to stick the landing. When Rep. Crockett was asked what she would say to Musk, her response was “Fuck off.” Not that we can rally around THAT exactly, but at least she’s got the right idea.

*Not sure I love using the term “oligarchy” only because most people probably don’t know what that means.

The ACA Still Sucks and Walz Knows It

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