U.S. Medical Insurance Is Too Complex, Inefficient

The Affordable Care Act (ACA) was positive legislation bringing medical insurance to millions of additional Americans. But signing up for “Obamacare” forces many to make impossible choices.

ACA subsidies for private insurance were to begin exactly where an expanded eligibility for Medicaid ended. But the U.S. Supreme Court sabotaged that smooth switchover by allowing states to retain original Medicaid without extending eligibility.

In states that did not expand Medicaid coverage, many people therefore earn too much to get Medicaid, and too little to buy subsidized insurance.