ACA is in trouble and could be on course for a death spiral

[magical thyme]

20. Some facts & analysis from NBER & HHS, via Naked Capitalism

I've been one of the "above poverty" level who didn't or barely qualified for some subsidy, but could do the math and knew I'd end up in the red and would have nothing set aside for actual health care. So my plan has been, and remains, pay the penalty until it's the same or more than forced insurance. I also was burned big-time by a top health insurer, so trust them about far as I can spit. I also, as a health care worker, understand the difference between a health care insurer and a health care provider. And I know which one is synonymous with parasite.

http://www.nakedcapitalism.com/2015/10/obamacares-open-enrollment-period-to-begin-faces-challenge-of-selling-to-those-whove-done-the-math.html

Officials are eyeing about 10.5 million people who could buy coverage through HealthCare.gov or state sites, often with federal subsidies to offset premiums, but who have resisted signing up as the law rolled out.

From a June 2015 study outsourced to the Robert Wood Johnson Foundation:

Cost remains the main barrier to insurance. Those who have looked made a calculated decision based on more than just the premium. They also consider out-of-pocket expenses, deductibles, co-pays and other factors in their decision.


From NBER working paper number 21565,
[E]ven under the most optimistic assumptions, close to half of the formerly uninsured (especially those with higher incomes) experience both higher financial burden and lower estimated welfare

“Most uninsured will lose and, according to our estimates, will prefer to remain uninsured at the current penalty levels for violating the individual mandate,” the report continues.