The insurance companies are not excited. ACA was a giant kick in the balls to most of them.
Many of the people receiving insurance for the first time (hell even currently insured) have no idea how insurance works. They went out and got that surgery or whatever else not realizing that insurance doesn't pay for everything. They didn't understand the concept of deductibles and co-pays, for example. My sources include my personal experiences and here's a Forbes article:
http://www.forbes.com/sites/brucejapsen/2016/03/13/americans-dont-understand-basic-health-terms-let-alone-obamacare-costs/#2c59edd3359e. Obviously, this has caused massive issues with claims. Whatever plan Trump comes up with, it better be to greatly simplify how insurance works so that people can actually understand it and use it.
Many of the insurance companies waited to build any systems or implement any changes until the courts ruled that ACA was constitutional. Then, our government only gave them a few months to be ready for it. Guess what happened? Huge payouts were made to everyone from software firms to hardware companies, training, etc., all in the effort to be prepared. We all have heard the problems with the government website, but what you might not have heard about is that the site is still not actually working as expected after several years of enrollment cycles. They are still sending all kinds of bad data and insurance companies are still struggling to work with the data while the government hits them with massive fines. Any change by Trump will likely mean significant work on the costly investments that have been made the past few years.
Because of the changes in ACA to remove denial of coverage, insurers have been forced to change how they do business. Underwriting is essentially gone. Instead, its been replaced by care management. Of course, the government is still putting standards into place, so care management is a complete mess. One of the crucial parts of care management is the open, free and secure transfer of data. For example, to manage your health episode, I may need to get details from multiple providers. My proprietary system may need to talk to your proprietary system. Well guess what? Proprietary system 1 isn't going to just open up their software for proprietary system 2 because they are competitors. This is actually starting to change, but its still a few years away from where it should be. That said, this is the best part of ACA and the part that rarely gets stated. All kinds of companies and products are sprouting up to help you manage your care. Apple health kit is a great example. Look at all of the devices now available for monitoring your care. Its all driving to lower your risk so that insurers aren't paying out to some 600lb guy for his diabetes when he could have put the fucking fork down or had a salad instead of McDonalds for every meal. By reducing risk and managing care, we should become healthier and our insurance rates should go down. Unfortunately, people are really stubborn and they like to drink heavily and smoke and all the other wonderful vices that are out there. So, I think its a noble cause, but one that is set up for failure.
The funniest part of all of this is that Trump has people so worked up across this nation, its going to result in all kinds of increased stress and anxiety. This stress and anxiety will result in... health problems. Also, what do you think is going to happen when these companies start hiring back American workers? Well, they are going to continue to get their profit margins. They will do it by hiring you back, but "asking you" to work a lot of extra OT. Don't believe me? Its been happening in several industries to this day, such as technology. Guess what all those extra hours do? Bingo, extra stress and health problems. I'm sure the insurance companies don't even think or care about this, but they will when claims start pouring in for mental health and well-being, addiction, etc.
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