Please, please don't be believing what Republicans say about the Affordable Care Act (aka Obamacare). They insist immediate repeal is the only remedy for problems that don't really exist and they ignore improvements that could make it better.
A fundamental of insurance is making the pool of payers and beneficiaries as broad as possible. Mandates to get insurance do that. They're much like requirements to insure vehicles or homes mortgages. With health insurance, sooner or later, most people are going to need to use it. Unless it is required and affordable, millions simply won't have it when the need arises. Republicans call it "freedom" to eliminate the mandates, but no person can truly be free if they're injured, sick or economically stressed.
Republicans proclaim the ACA a "disaster," "collapsing under its own weight," "in a death spiral," etc., but the actuaries say otherwise. It is actually succeeding - over 20 million now with access to care, millions who have gotten care they would not otherwise have received, including preventive care, cancer treatment, emergency surgeries and drug abuse treatment, lives saved, bankruptcies avoided. Thirty-one states plus D.C. that expanded Medicaid are doing very well, hospitals have stayed open, and the health care and small business sectors of the economy are growing.
It's failing, Republicans claim, because premiums are rising. Never mind that premium increases are smaller now than they were before ACA and that most of the increases are not paid by individuals. It's failing, they say, because insurers are leaving the market. But neither of these are the measure of success of the health insurance system and both of these were caused in part by Republican-dictated limitations on backup reinsurance for insurers. The measure of a health care system is the care it gives to people, not how well the insurers are doing.
What are the Republican solutions in the bill they're ramming through Congress without hearings, discussion with the public and amendments?
* Cost controls? - Zip, nada, zero proposed
* Huge tax cuts for the well-to-do, including tax breaks for insurance companies that overpay their CEOs. They're there and are the real purpose of the legislation!
* "Buying insurance across state lines" -- Deceptive rhetoric because actually it means doing away with minimum standards for insurance coverage. We buy insurance across state lines already, but all plans must cover a minimum of services. Doing away with standards returns us to the bad old days of junk insurance that didn't cover care bought in a state with lower standards.
* Health savings accounts - existed before and after ACA but serve only the well to do.
* High risk pools -- also there before ACA and don't work because they wall off those with the highest expenses (the greatest need) into high-cost pools.
* Reduced financial assistance for those receiving advanced tax credits - something sure to make many drop insurance despite need if it's no longer mandatory. Then if they can't pay for a couple of months, there is a 30% surcharge added to the costs they already couldn't pay in order to get reinsured.
* Block grants to states for Medicaid that don't fully cover the costs, and fazing out of Medicaid expansions whereby 11 million citizens get care. By the way, did you know that half of all babies born in the US are paid by Medicaid? Did you know that when we have exhausted all our resources at the end of life, Medicaid pays for nursing home and hospice care?