The ACA made things better than they were by eliminating maximum benefit amounts, implementing out of pocket maximums, implement maximum age rating factors, and removing all pre existing condition clauses guaranteeing access to healthcare. The individual mandate ensured that all of these increases in access to healthcare could be paid for by forcing young and healthy people to pay premiums. Without the individual mandate, premiums would have had to be even higher, causing even more people to not buy insurance, etc.
That the tax code was not updated to remove the tax benefit for employers, or give it to individuals is a shortcoming (and has long been a handout to big businesses prior to ACA). What really needed to happen was forcing everyone into healthcare.gov onto a single marketplace so healthy lives wouldn’t be locked up in employer sponsored risk pools. Then the costs would truly be shared across the whole population, and sufficient healthy lives would exist to enable multiple insurance companies to compete.
Or we could have gone with taxpayer funded healthcare and made it all simpler. But that obviously wasn’t in the cards.
That the tax code was not updated to remove the tax benefit for employers, or give it to individuals is a shortcoming (and has long been a handout to big businesses prior to ACA). What really needed to happen was forcing everyone into healthcare.gov onto a single marketplace so healthy lives wouldn’t be locked up in employer sponsored risk pools. Then the costs would truly be shared across the whole population, and sufficient healthy lives would exist to enable multiple insurance companies to compete.
Or we could have gone with taxpayer funded healthcare and made it all simpler. But that obviously wasn’t in the cards.