Bottom line is, contrary to what many pro-ACA advocates say, most healthy people are perfectly happy without health insurance (even if their purely emergency care is taking a toll on tax-payers).
It's not just some accounting problem that vanishes into the general economy, and they all go on being happy forever as if nothing special happened. (That is a privilege generally reserved for corporations and wealthy managers.) Someone somewhere actually pays in lost opportunities of great importance. Often it is the same young, and perhaps marginally employed person who thought they were doing just fine until they had one big bill to shell out (it may be originally mediocre in relative terms, but beyond their means) -- and suddenly financial recovery is nowhere in sight.
I am more or less healthy on the whole; I hardly visit facilities for much of anything. However, if you hardly use health care and simply stay aloof with trust in your young age or fortunate constitution, then when stuff does blow up, you can land in big trouble. I passed around two years of pretty much skimping on (also read: not getting) dental care. This was partly because $100-200 for a cleaning here or there is a chunk of money when "full-time" student loans are calculated at a somewhat below what you actually need for school fees plus rent, food, transportation and things like clothing in a major city... And partly because even after school, the job market was not friendly to me and I often needed to keep my extra odd hundreds to tie me over for a few weeks between
what shorter-term clerical jobs I could get. And honestly, even had I gone in for regular checkups, I doubt that I would have felt secure enough to shell out for things like fillings before it became physically painful. With my teeth, apparently that doesn't happen until I need some major treatment.
I had a root canal which was already beyond my means (my insurance paid in lumps of around $400/semester, didn't include any
dental at all). I was able to pay for the operation with Care Credit, which gives you a year to (maybe, somehow?) sort things out but then starts whopping you with major credit card level interest rates. I had no other way to pay. The economy was still feeling the recession and I was then a full-time student, not willing to simply give up my chance of a career certification to commit to only full-time work at some unrelated entry-level job, that is if I could even get some (dubious).
A little ways down the road like that, I reached a point where it was obvious that not only was I not keeping up with the rather staggering interest (and late penalty) payments on just that one, to me, rather whopping root canal bill... It was also going to destroy my credit rating so fast that I wouldn't have flexibility to choose common options in location, transportation (say if I wanted to get a car), education, or job training. More immediately, creditors come along afer a few months of missed payments and sue for the right to drain whatever is in your entire bank account
-- and they can do this over and over if they feel like it -- possibly even ordering a bank to raid paychecks as they appear. Voila, kylie says fuck this, I don't live to work multiple insecure jobs only to have paychecks ripped away as they come on terms I could never repay, and leaves the country. Prices go up somewhere else in the world of insurance and credit, I suppose. Or maybe the company could just afford to take a loss of a few grand now
and it'd be done -- but really, as if they're ever satisfied with that.
Lots of people may be perfectly "happy
" at any moment with a situation that is likely to sooner or later either bite them personally, or shrink their economy indirectly, or harm someone else they know more visibly. Maybe they shouldn't be, and maybe they wouldn't be if they looked into where all those costs for belated care go. Granted, whether ACA will actually undo this pattern or not is another question.