than they were before. Which means that it will never be the most cost-effective delivery of health care because additional layers of profit are built into it, and there will still be large numbers of those who need it most who cannot access actual *care* despite being insured, because of copays/deductibles/etc, and those who fall into the medicaid expasion gap (yes, due mostly to RW state govts but the fact that it leaves shit like that up to them made it a weaker bill).
And the more they are codified, the harder it is to get their influence out of the process of changing it (lobbying, bill drafting, campaign donations, etc). In that sense, it isn't even a step forward. For-profit companies are part of the foundation of our health care funding and delivery system. It's the law.
It was weak. It's only the 'best we could do' because of people who say it's the 'best we could do'. We are near last among our so-called peers in terms of health care. We spend more than most everyone else with worse access, worse measurable outcomes, it is fucking absurd.
And I say all this as someone who is lucky enough to qualify for serious subsidies (self-employed, low income) and is relatively healthy. So it's working for me. I'm insured for the first time in awhile.
But if something happened and me or my spouse needed more medical attention I'd probably be in serious trouble financially with our annual out of pocket max. And I know a ton of people in that situation, especially where one partner can't work due to health reasons. Many people who need it most are still struggling.
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