When the steaming wet turd known as the ACA was dropped in our laps, neither me nor my friends could understand how the fuck it was supposed to help anyone not already basking in middle-class or higher, dual income/partnered comfort with their existing “good” medical coverage and a nice rainy day fund to cover those pesky deductibles.

And suddenly, mandatory medical coverage every month, miss even one in a year and you get suckerpunched with a tax penalty during reporting season, for being an uppity little prole and not shoveling your dues into the black hole that is the corporate insurance racket.

I examined all the plans available to me. I saw no practical difference between the tax subsidized “bronze” trash I could actually afford with my precarious employment / income situation vs. the mediocre shit the employers generously deducted my paychecks for. Any of them would’ve financially destroyed me for years if I ever had to use them and pay the outrageous deductibles, even the out-of-pocket fees for routine shit would’ve been crippling. And in true American tradition, literally none of the ACA offers came with dental coverage, and only a select few had vision.

BUT! BUT. NOW I HAD LE CHOICE IN LE GLORIOUS MARKET™ SO I COULD JUST SHOP AROUND FOR TEH BESTEST PLAN LIKE I’M BUYING FUCKING ICE CREAM AT DAIRY QUEEN AMIRITE. AcCeSsiBiliTY!!1!1!!!oneoneeleven

The “Affordable” “Care” Act was neither affordable nor did it provide anything resembling care except to the insurance industry’s financial spreadsheets. I would like to get printed on my grave’s headstone that neoliberalism and capitalism are the literal, ideological forms of what social science has defined as sociopathy and cruelty, conceived by some of the most vile and despicable cockroaches this earth has ever borne.

But who the fuck am I kidding. I’m going to die so fucking poor I won’t even afford my own obituary in the local news (which got sold out to fucking Gannett decades ago), let alone a burial and headstone.

Arguably the mandate is actually necessary to make the ACA work. Here’s a historical breakdown of how a very similar regulatory configuration to the current version of the ACA (ACA plus some changes by Trump) wound up basically destroying the health insurance market in WA in the 90’s over the course of about six years: https://www.washingtonpost.com/blogs/ezra-klein/post/health-reform-without-a-mandate-lessons-from-washington-state/2012/06/16/gJQAosKghV_blog.html

It’s sort of a good case study in how capitalist markets inherently can’t deliver what people need. The reform model Democrats have embraced is the highly regulated oligopolistic market model, but this is a bureaucratic shambles that leaves out tens of millions of people anyways and is incredibly complex and delicate and therefore vulnerable to political sabotage by their enemies.

In order to defend the mandate (therefore the approach of the ACA as a whole) you have to have a catastrophic lack of imagination, though. You have to actually think nothing better is possible. And Democrats wonder why people don’t like Joe Biden.