Contrary to what Republican opponents of the Affordable Health Care Act want you to believe the program is working well in areas that have multiple insurers offering insurance. So why is there a problem in other areas? Two factors are significant in the program not working. First, states that didn't expanded Medicaid eligibility have less success offering affordable insurance. Those people eligible for expanded Medicaid tend to be less healthy and putting them in the market pools raises the costs of those pools. States that expanded Medicaid mostly have more affordable private market pools. Second, the lack of a mandate to purchase insurance has kept younger, healthier people out of the private market pools. These young people are likely to purchase insurance only after they have an illness. It is like being able to buy home insurance after you had a fire. Think about how healthy the home insurance market would be if you could buy the insurance after you needed it.
What will come out of the Republican controlled Congress soon will not address either of these issues because their intent is not to fix the issues with the program but to propose ways that will further weaken the program so that they can kill the program and return us to the old situation of having millions uninsured. Their talk of improving the program is just a cruel smokescreen for their real intent. It seems that the United States will continue to be the only major Western democracy that doesn't view healthcare as a right. I guess we have to take "comfort" in the fact that our budget priorities still give us the military capacity to "bomb the *hit" out of our perceived enemies.
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