Sanders revs up ‘public option’ fight after Aetna leaves ObamaCare

[still_one]

49. I suspect most of this problem is due to states that were against the expanded Medicaid, and never

setup exchanges in their own states, along with an active campaign in those republican states encouraging people not to participate in the ACA.

The ACA, as Medicare needs everyone to sign-up to work effectively. That is why Medicare has a very strong incentive to sign up when one turns 65, and if they don't, there will be substantial lifetime premium penalties

All insurance programs balance those who are healthy verses those who are not. Since there are usually more healthy folks in the pool, their premiums offset the medical costs for those that are not as healthy.

For those people who are not covered by insurance by their employer or some other way, this subset of the populace is required to sign up for the ACA, or they may be subjected to a penalty. There are exceptions to this, such as if the premium costs exceed a person's income by a certain percentage, they are exempt from the penalty.

In addition, income levels and family size are taken into consideration where many can get reduced payments through subsidization.

A lot of eligible folks still haven't signed up for the ACA, and a lot of the red states refused to expand Medicaid. This has all contributed to the issues why some of these insurance companies are leaving those states where it isn't feasible, while at the same time they are remaining in other states where it is feasible.

While the ACA has issues, and some serious holes, if everyone of those states had been on board there would have been far less issues like this.

When you have young healthy people with the opinion that "I don't need insurance, and the government cannot force me", in large enough numbers, that effects the ACAs efficiency.

Another issue which the media likes to ignore, is that for any program such as the ACA, it takes years for it to get off the ground. As more people sign up, and get on board, the dynamics of the ACA will move into a more feasible solution.

If the Democrats are able to control Congress, and the Executive Branch, I would expect the ACA deficiencies addressed. I could even visualize where an option for

Medicare also isn't free, and depending on the level of coverage it can get quite expensive when you factor in supplemental policies, drug costs, and dental costs.