How affordable are the Health Care Exchanges really?

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6. how affordable will health CARE be?

We won't know until everything settles down. Nobody on either side can tell you. We'll learn a lot the first year.

Will insurers keep rates low (or lower them)? Or need to raise them? Or raise co-pays? Or deductibles? Since 80% of premiums must go to medical costs, they LOSE money if they decrease medical costs but can argue for increased premiums (and profit) if costs go up. The MLR gives them an incentive to raise costs and cover EVERYTHING.

How will regulators react? Allow premium increases? Or deny premium increase and have insurers say they want to cover EVERYTHING but the "death panels" won't let them?

How will providers react? Will they accept the insurance? Or go to a cash basis? Will cash providers be outlawed?

Will improved records management and simplified insurance increase providers' profit without increasing rates?

Will doctor's offices' become production lines which push as many people through as possible? With more mis-diagnosis and more return trips (and additional co-pays). Practices are streamlining their patient care already and have to do more if reimbursement rates go down.

If too many providers drop out of networks, how long a drive/trip will it take to see a doctor? How long will the wait be? An all-day trip to the doctor will cost a day's worth of wages. Some medicare patients currently have all-day trips to see a doctor who takes new medicare patients (my dad drives one of them when his friend needs to see a doctor for a "routine" visit)

Things may turn out great. But don't look at low initial premiums the final success. Insurers and providers will continue to "improve" their services (with profit goal) as they learn how the law works and will continue lobbying. If ACA supporters stop fighting, it will go the wrong direction very quick.