At least basically, we do. It's just that the content is so bad that no one wants to talk about it during an election cycle.
Kaiser Health Care calculator:
http://healthreform.kff.org/SubsidyCalculator.aspx
This will allow you to enter an income and a family/single status. Say you are not eligible for employer insurance to find out what happens to you if you are forced on the exchange. Some examples:
35 year old, single, income 25K
Required bronze premium 1,726 annually, with the subsidy coming in the form of a tax credit of $2,236. How that credit works remains to be seen - here's hoping the IRS allows your withholding to change to account for it, because otherwise you'll have to cough up the entire estimated premium cost of $3,962 in the first year and get reimbursed the second year. That would effectively be impossible for many, so you would have to pay the fine and you wouldn't have insurance.
Your maximum out of pocket costs would be $3,125. This does not include the premium - that's extra. So if something bad happens you would be expected, with an income of 25K, to pay $4,851 that year before 100% coverage kicks in. On a 25K income, this makes "affordable" a total joke.
The "actuarial percentage" is 73%, which means your average copay is 27%. So if such a person had a health condition, and had $20,000 in medical bills (not extreme - one car accident will put you over, or many illnesses requiring diagnostic testing) in a year, the first 10K of medical bills would cost (on average) $2,700. The next 10K of medical bills would only cost you $425.
Same person with a 35K income:
Required bronze premium is $3,325.
Maximum out-of-pocket costs are $4,167. Thus the maximum yearly medical bill would be $7,492. The actuarial payment percentage is 70%, so if you rack up 10K of medical costs, on average you will have to pay $3,000. The next 10K each year would only cost you $1,167.
And so it goes. Family example:
Family of 4, approximately median family income of $50,000, age of primary policy holder 35.
Out of pocket premium is $3,385, plus out-of-pocket costs of $6,250.
The actuarial coverage is 73%, so on average your copay for each $100 of medical services is $27, or $2,700 for each 10K of medical services. The probability in any given year that you will have over 5K of medical services is much greater than for the single. Families who have an ill member will probably pay $5-7K in medical costs each year.
Final example to show what's going to happen to the older persons:
Single person 62, income of $40,000 (distinctly above current average wage):
Required premium is $3,800, plus out of pocket cost of $4,167. Actuarial coverage percentage is 70%, or an average copay of $30 for each 100K in medical bills.
So the total cost for one year's coverage plus 10K of medical bills is $3,800 + $3,000 = $6,800. The next 10K in medical bills costs you $1,167.
Since the older person has a much higher probability of incurring 10K in medical bills each year (consider prescription costs alone), older people will be burning right through their retirement savings before they ever retire unless they have employer-paid medical coverage.
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