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As with all types of bills of this sort, you have to way the good parts with the bad.
Good: Expansion of community health centers(underfunded).
Good: Forbidding insurance companies from using preexisting conditions to drop coverage or not pay claims(doesn't go far enough).
Good: Expanding Medicaid to single adults below a certain income level(doesn't go far enough)
Good: Subsidies to alleviate spending on premiums(doesn't go far enough).
Good: Cost sharing to alleviate out of pocket expenses(doesn't go far enough).
So So: Exchanges that require at least 1 non-profit and/or co-op per state(so so because even non-profits can be abusive)
So So: 85% of premiums have to be spent on medical care(not really going to be effective, especially in the long run, in slowing down premium increases).
Bad: Mandates to buy insurance from employer if they offer it, from exchanges if they don't.
Bad: Weak oversight of claims process, internal(within insurance company) appeals for claims and lack of federal framework for external appeals process means those who live in republican or right-democrat states are screwed, to put it simply.
Bad: No framework for cost controls, Government still can't negotiate for lower medical care costs, nor can states at this time.
Bad: No strict limitation on claims denial rate, we don't even know what percentage insurance companies can deny before the government can penalize them, or how they will be penalized.
Bad: No framework for transition to a better system, either public option or single payer that is enforceable.
Bad: The Anti-Choice provision.
As I said, its a balance, some bad, some good, but the good doesn't go far enough, and frankly, the effects of the bad, particularly the overall lack of oversight mechanisms combined with mandates, may bite us in the ass later. I think the biggest problem is that a lot of us opponents are afraid that the overall effect of this bill is that we will add a lot of Americans to list as insured, 30 million or so, and yet they still will not have access to affordable health care. In other words, the stats will look good, most Americans will be insured, but its only good on paper.
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