The states that have established exchanges of their own as was envisioned by the authors of this legislation have seen their state run exchanges be very successful in enrolling people with many examples of joy by people being insured for the first time in many years, some in ever. Those states that did not accept the responsibility of state run exchanges have, by default, allowed the federal government to operate the health exchanges. Ironically, this has resulted in a favorite prescription used by conservatives to allow insurance companies to operate across state lines. The down side is that it places undue strain on an enrollment system that was not anticipated to handle so much national load. It will get better.
A large part of the discontent with the insurance itself results from insurance companies having to provide policies with basic coverages. That has resulted in cancellation of inadequate policies that were the darlings of the young, invincible population. The lobbying effort to keep the insurance companies in business and to prevent the competition of a public option have made these policies unattractive to insurers hence the cancellations. However, in many cases subsidies will make up the difference.
Another part that is causing cancellations is the excise tax that is due to take effect in 2018. Insurance companies and employers are already changing policies to avoid this 40% tax on "cadillac" policies. Those policies will be available at market rates. This was done to encourage greater responsibility by consumers for health care choices. Also a conservative tenet.
http://www.telegraph.co.uk/health/expathealth/8308330/Expat-guide-to-New-Zealand-health-care.html
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