ACA health insurance will cost the average person 75% more next year

The ACA was originally designed as a "three-legged stool" of nondiscrimination (insurance companies can't charge higher rates to sick people), the individual mandate, and subsidies.

If you remove one of legs of the stool, the market becomes unstable and you see price spirals like this.

Jonathan Gruber (MIT econ professor, and one of the designers of the Affordable Care Act) gave a fairly detailed talk about how and why they designed the ACA the way they did, learning from a similar law in Massachusetts: https://youtu.be/2fTHqARiV_Q?si=SRC6Np-rjgUgAe4Z&t=679

Yep, the ACA was originally RomneyCare.

Mitt Romney took the plan from the Heritage foundation (yes, the conservative neocon think tank). Hard low-controls capitalist plan.

Heritage foundation made this plan after Hillary Clinton pushed universal healthcare in 1994, as first lady. Howls of 'death panels' were heard all over republican talking points and radio shows.

(The 'death panels' aka rationing was seen as bad for government to do. However, we see a new type of rationing, based upon how much patients cost, and then denying care. That lead to the UHC execution, then approving more procedures, then getting sued by shareholders for that. Personally, government death panels are preferred to capitalist death panels.)

Put simply: Obama passed republican legislation put forth by a republican governor and a republican thinktank, and was deemed a socialist. And now, the program is basically destroyed.

Bipartisanship is dead. If you want to win, play to win.

Playing to win is dead. Current climate is play to kill yourself, so long as your opponent also does but suffers more.

I'm somewhat hopeful with Gavin Newsom's posture making an example, I wouldn't vote for him, but I like the aggressive PR position he's taken, his willingness to gerrymander just as the other side has been doing forever. That's what I mean by bipartisanship is dead. You can't negotiate with the other side, they do not want to negotiate, they want to win at all costs for ideology, so you can only do your best to disempower them. If you try to play fair with a counterparty who does not believe in acting in good faith or playing fair, you have default lost. You can't have a functional democracy when one side rejects democracy (massive efforts to disenfranchise voters, gerrymandering, etc) because they can't win democratically. There is no reason you can't have empathy while punching down at bullies, because if the tables were turned, the bullies would put their boot on your neck ("paradox of tolerance"). So, start punching down.

Edit:

In the context of this topic and the near term, this looks like blue states implementing universal healthcare, and letting red states figure it out themselves (considering how dependent red states are on the federal government [1] [2]); Oregon is up first [3]. You can increase state taxes to fund this, reducing tax dollars sent to the federal government, if properly engineered.

[1]. https://time.com/7222411/blue-states-are-bailing-out-red-sta...

[2] https://usafacts.org/articles/which-states-contribute-the-mo...

[3] https://www.hcfawa.org/oregon_s_path_to_universal_health_car...

> In the context of this topic and the near term, this looks like blue states implementing universal healthcare, and letting red states figure it out themselves…

The risk here will be sick people (and their high costs) moving. As with how Chicago's illegal gun problems mostly come from Indiana.

Most people cannot afford to move. 60 percent of Americans cannot afford a basic quality of life. Those who can move will move to states that can afford this, and are the economic engines of the US economy (California is the world's fourth largest economy, for example). Those who voted for this and don't believe in subsidized healthcare should stay where they are, as I presume they believe universal or subsidized healthcare is "socialism" they don't want. I support the rapid reduction of healthcare services in those areas [1].

I pay taxes (>$100k/year total state and federal tax burden), I support universal healthcare, and I am willing to pay more for everyone to be covered.

[1] https://ruralhospitals.chqpr.org/Overview.html

> Most people cannot afford to move.

That calculus gets a little different for some folks if the move comes with subsidized universal healthcare and better social services.

> Those who voted for this and don't believe in subsidized healthcare should stay where they are, as I presume they believe universal or subsidized healthcare is "socialism" they don't want.

We agree, but "The Only Moral Abortion is My Abortion" rule applies. https://joycearthur.com/abortion/the-only-moral-abortion-is-...

If you can’t change their mind, and you can’t change their vote, and rural voters die faster than urban voters because of lack of access to healthcare services, state universal healthcare is the best we can do until electorate turn over through rural age out can improve political outcomes. Until then, we are held hostage by the irrational and unsophisticated with votes, which is unfortunate but the reality of the situation.

It’s exhausting being dragged by low empathy unsophisticated humans frankly, I am personally over it. I was naive about human nature, hard lessons learned.

"and rural voters die faster than urban voters because of lack of access to healthcare services, state universal healthcare is the best we can do until electorate turn over through rural age out can improve political outcomes."

Is there any evidence that universal healthcare would address the facility and physician shortages in rural areas? It won't make much difference if you give people coverage if they still can't exercise that coverage, or just get subpar care in many rural facilities. It seems that many rural hospitals have turned into glorified helipads to transport many patients to bigger cities.

For example, the uninsurance rate for urban vs rural is only 1-2%. It seems like that wouldn't explain the larger gaps in health outcomes. It seemsbother factors would be more important.