The ACA attempted to "share responsibility" by requiring individuals to purchase health insurance as part of a group of "self-payers." Self-payers previously purchased health insurance as individuals based on their own level of healthiness. The ACA caused the healthy to pay more so that the unhealthy could pay less. Since the healthy may someday become unhealthy, this seemed to be fair.
However, the ACA created a system where only the self-payers shared the responsibility for the unhealthy people from both the self-payer group and the employer-provided group.
49% of Americans get health insurance as a fringe benefit at their place of work (the employer-provided group). However, when a member of this group becomes catastrophically sick and/or injured, they can no longer work. Since they cannot work, they lose their employer-provided health insurance. They fall into the self-payer group at the time when their health care costs are extremely high.
These two groups (the 7% of self-payers and the 49% of employer-provided) represent the entirety of the private sector health insurance market with a total population of 56% of Americans.
The self-payer group has become the high-risk-pool for all private sector health insurance in America. Because of this, the little-guy is paying outrageous premiums, and businesses are being shielded from the true cost of health care in America. This has caused the ACA self-payer death spiral. Where is Bernie Sanders to tell us that the system is rigged?
In case you were not aware, FairwayFrank was a vice president at Computer Sciences Corporation's Health Plans Solutions division. Frank knows about health insurance.
Bottom Line: the "shared responsibility" spirit of the ACA shared the cost of the unhealthy of the entire private sector health insurance market (56%) among ONLY the healthy members of the Americans that purchase their own insurance (7%). Those that get health insurance from their place of employment (49%) do not take on any of the "shared responsibility." That is why the self-paying market is imploding.
Insurance premiums have replaced taxes as the means to fund the health care safety net for those with preexisting conditions. However, the structure of the ACA is discriminatory with regards to who pays these higher premiums ('taxes'). Any constitutional lawyer want to file a suit against the federal government under the uniform tax clause of Section 8? Chief Justice Roberts has declared that the "shared responsibility penalty" of the ACA is a tax. Is this a discriminatory tax? I believe that it is and I believe that the 'taxes' embedded in the self-payers' premiums are also discriminatory.
We are beyond the point where we will ever eliminate the preexisting condition safety-net. Nor should we. Therefore, we must fairly distribute the "shared responsibility" among ALL those in the 56% group of the private-sector health insurance market. The only other option is what the Democrats had designed the ACA to provide, a single-payer system. It is my belief that the ACA purposefully included the design flaw described herein to cause the self-payer market to collapse after a few years of the added entitlements of the ACA having taken hold so that America would have to accept a single-payer system. Well, I think believe is a better way. The Trump administration must thread the needle on this matter with an improved American Health Care Act that both parties can support.
Watch this short video on You Tube to learn the details and how this situation can be fixed: https://youtu.be/0dzi2UkH44g
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