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And if you are relatively healthy and able to pay your regular doctor bills out of pocket, ACA made catastrophic insurance illegal (because of the minimum requirements). It's sort of like making car insurance require $50 copays to the mechanic. Sure, it's nice if you need an engine rebuild, but paying for all that makes the insurance a lot more expensive if you have a reliable car. There's no need for me to pay the doctor's bill and the insurance company's profit+overhead, I'd like to have the option to pay normal stuff myself and only insure something too large for me to pay.



If healthy people could opt out of insurance, it would get really expensive for the not-so-healthy. That's why mandatory insurances are quite common.

Wheter it's a good idea to do this via private for-profit insurance and healthcare is another question. I prefer to just pay it via taxes.


This might not be quite what you want, but the ACA does allow for High Deductible Health Plans (HDHP). Those have consumers paying out of pocket for normal stuff, using a Health Savings Account (HSA).

https://www.healthcare.gov/glossary/high-deductible-health-p...


Which are, nonetheless, rather impressively worse in basically all respects than the old medically underwritten individual plans. Other than the fact that anyone can get them, of course.

I’m not saying that the ACA was a bad law. I’m saying that a not-so-nerdy voter contemplating whether ACA is a great achievement of the Democratic Party is likely to be unimpressed.


Worse in some ways, better in others. The old individual plans usually had serious limits on coverage of pre-existing conditions. And they had lifetime coverage limits which could be exhausted by a single serious illness or injury.




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