...The federal government did not take "control" under the ACA. What the federal government did do was eliminate the millions in junk policies that were regularly being issued across this country...
Everyone loved those cheap policies until they had to use them. Most of these policies were legacies of old indemnity policies that fell out of favor in the 1980s. The typical scenario was that someone would pay for these policies for years and then when they were sick, they would discover that few physicians and hospitals would accept the policy, either because they were "out of network" or because the limits in the policy were so restrictive that it would not cover the service (which in effect, makes the patient "self-pay").
When you're "out-of-network" you pay full price for services and you don't get the discounts that you would get if your insurance company was contracted with the provider. Since most insurance policies come with a 50-60% discount, that's a lot of money that you have to pay out-of-pocket.
In a 2013 issue of Time Magazine, Steven Brill wrote an article called "
Bitter Pill" Why Medical Bills Are Killing Us" where he gave several real-life examples of people who had these junk policies:
The woman in the business office matter-of-factly gave Rebecca more bad news: Her insurance policy, from a company called Assurant Health, had an annual payout limit of $100,000. Because of some prior claims Assurant had processed, the S.’s were well on their way to exceeding the limit. Just the room-and-board charge at Southwestern was $2,293 a day. And that was before all the real charges were added. When Scott checked out, his 161-page bill was $474,064. Scott and Rebecca were told they owed $402,955 after the payment from their insurance policy was deducted.
At this point, I'm convinced that when Barack Obama said "If you like your insurance, you'll be allowed to keep it" [paraphrased?], he was actually unaware of how many policies were out there, that were utter rubbish.
I think the quote was "If You Like Your Doctor, You Can Keep Your Doctor".
There was a backlash from people who had "junk" policies that didn't meet the ACA minimum requirements. To quell the backlash and to give people time to find new policies, Congress did allow some of the junk policies to be grandfathered for a period of time.
This reminds me once again of what my high school friend who became a doctor has said a number of times: he could do so much more for people if an annual physical & checkup was free so there was a data baseline to work from.
Under some of the ACA policies, you
are allowed a free physical (labeled as a "wellness visit")
if you're on Medicare. This corrected a problem with Medicare- that Medicare will only pay if you're sick. The change allows people on Medicare to see their PCP one a year just to get their labs done and to get a "check-up" without having to wait until they're "sick" so that Medicare will pay for the visit.
Some of the Individual Plans on the Marketplace have a similar clause but it's not mandated in the ACA. Honestly- it's not much of a value since it just saves a small copay. More beneficial are the ACA's preventative/screening diagnostics: the ACA says that you are entitled to copay-free, non-deductible screening for diabetes, obesity, cholesterol, and various cancers, as well as counseling for drug and tobacco use and healthy eating, among others. For people over age 50, this includes a "free" diagnostic colonoscopy.
If the ACA were repealed these changes that allow favorable payment structures for wellness and diagnostics would also be repealed.
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