By far, the best provision in the law is the Medicaid expansion intended to cover all people near the poverty line. This should not only eventually be responsible for the bulk of the coverage expansion, but it should do the most good for people.
While not perfect, it will probably do a better job protecting people from financial ruin caused by medical bills than the high deductible private insurance plans which will dominate the exchanges. Since the truly sick may find it hard to maintain a job and therefore stop qualifying for insurance on the exchange, it is likely Medicaid will end up serving as the real safety net.
The problem for “Obamacare” is that most people will probably just see this expanded Medicaid as simply Medicaid, a program started decades ago. When people sign up there will not be an “Obamacare-version Medicaid” and “traditional Medicaid,” it will all be Medicaid. Quickly, it should become hard to really figure out if any person would have qualified for Medicaid with or without the new ACA.
Expanding Medicaid will likely make the already popular Medicaid program more popular, but this may not rub off on the idea of Obamacare.
It is conceivable that only the new exchanges are likely to be really thought of as “Obamacare.” That is going to be a program used by only a small subset of the population where many people are forced to pay high prices for low quality insurance and face large back tax issues if their income increases at all during the year.
Photo by Rob Gunby under Creative Commons license