So what about the failing part?

Shoot. I forgot another part. The government also provides subsidies so people without a lot of income, but too much to qualify for Medicaid can afford coverage on the exchanges. The subsidy is based on income level and the cost of plans on the exchange in question.

Here's the what's up with the failing. One of the flaws in the ACA is that the penalty for not getting insurance isn't very high. (And now the Trump administration has announced it won't enforce it at all) So, participation in exchanges by young, healthy people isn't that great. That has driven up the prices on the exchanges and hurt the profitability since the insured population is older and less healthy than anticipated. Aside from higher prices, this has led to providers pulling out of the exchanges leaving some with only one or even no providers. That is what the failing part is all about.

Also there are a lot of lot of complaints that the deductibles in the plans are too high, though that boils down to the fact that health care is super expensive here.

Another problem is, well... remember how a bunch of states opted out of Medicaid expansion? Well, those people don't make enough to qualify for the subsidies since the law assumed they would be covered by Medicaid. They are out of luck.

The Dems have wanted to adjust the law to help, but since never had control of congress after passing it and no Republican dares show any support for the ACA, that isn't possible.

I hope that helps.

Very nice, Gud!

I would also add that the fact that future of the system has been so up in the air for the last six months has made companies even more squirrely, so people in some places have very few options for "Obamacare" plans on the individual market. Edit: Which is not necessarily a reflection of the profitability of the system, just the uncertainty.

I do think it's important to reiterate that most people have either employer-based insurance or Medicare/Medicaid government insurance.

I don't think that conservative pundits have any idea what this whole orange fiasco is doing to the US's reputation in the world. Or perhaps they are just so convinced of American Greatness that they can't imagine anything could affect it.

Well, Fox News is stuck. They don't have a diverse viewership and that viewership is ardently behind Trump. So if they start saying anything negative about him, they will take a big hit. Meanwhile, they are the only news source trusted (along with a handful of super-conservative websites and radio shows) by that same viewership. They have to keep saying he's great and the more they do, the more they have to keep saying it. That drags the entire Republican party with it because Fox News is the most influential part of the party. Far more than the RNC or the Republican establishment.

I would also add that the fact that future of the system has been so up in the air for the last six months has made companies even more squirrely, so people in some places have very few options for "Obamacare" plans on the individual market.

That's a really good point.

That's fantastic, thank you Gud. Wow, 45 wasn't kidding when he said it was complicated. It might be the most accurate thing he's ever said!

I read something recently about why Americans have an aversion to state-sponsored healthcare; individualism and pioneer spirit and all that. But of course some people have to pay more and may not take as much out. That's how insurance works!

Sorry about all the typos. I was trying to be quick.

Yeah, uncertainty sucks. (I know whereof I speak, I've been in Brexit-induced limbo for the past year with no end in sight).

I do think it's important to reiterate that most people have either employer-based insurance or Medicare/Medicaid government insurance.

It always seems a little weird to me that there is so much drama over a pretty small part of the health-care system.

Wow, 45 wasn't kidding when he said it was complicated.

Yeah, it's crazy complicated and the rhetoric can be really misleading. The Republicans mostly complain about the exchanges, but the real target is usually Medicaid since there is more money there.

I do think it's important to reiterate that most people have either employer-based insurance or Medicare/Medicaid government insurance.

And for those of us that don't, it is insanely expensive, with huge deductibles, and about everything isn't covered.