My wife and I are fortunate to be covered under my company’s private health insurance plan…
Steve McGrath


One thing I think some people may miss is that, surprisingly, if you make below a certain annual income you do not qualify under the ACA in a state that has opted out. Ironically, you can be too poor to qualify for coverage under a plan that was devised to address the lack of health coverage for poverty-stricken people.

My daughter is 33 years old, she works part time as a County employee. She does not make enough to qualify. She is excluded from coverage because she lives in a state that chose not to participate and makes her eligible for Medicaid. She works hard at being as healthy and fit as possible and would be a positive on any actuarial table. She, and many like her, would go a long way in providing a stabilizing pool from which to leverage the staggering cost of administering policies for ill people. But…nope. Too poor.

The first mistake in devising this care was allowing states to opt out. I understand why it was done but that, as much as anything else, reduced the pool from which to curate experience which contributes to stabilizing rates.

ACA was badly neutered in order to get it passed and that made it a failure before it started. And to be clear I am speaking of the ACA itself and in no way mean to reflect on the people that benefited from having access to much needed health care.

Mandating coverage for pre-existing conditions that can range from minor conditions to catastrophic was just one failure looking for a place to happen.

Imagine thousands of people that have never had health insurance, and may not have ever received consistent health care as a result, coming into the ACA with not only known conditions but secondary and un-diagnosed illnesses. Suddenly, the system is flush with ill people, people that now have coverage and making claims.

It may appear to work short term but, eventually, the piper must be paid and paid well.

This country does need to address our health care system but it has to be done thoughtfully and very carefully. Yes, people have benefited from having the basic routine care that ACA made possible but if it is a system that cannot be sustained what have we gained?

More importantly, what will happen to the people that have received quality care and now are being told that the care that cost them $15 a month in 2016(as in the case of my best friend) now must fork out hundreds of dollars a month — dollars that they never had in the first place?

In other words…back to step one.

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