MIAMI, FL - FEBRUARY 13: Hisham Uadadeh walks out of Leading Insurance Agency after enrolling in a health insurance plan under the Affordable Care Act on February 13, 2014 in Miami, Florida. Numbers released by the government showed that about 3.3 million people signed up for health insurance plans under the Affordable Care Act through the end of January. (Photo by Joe Raedle/Getty Images)

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The Affordable Care Act is once again in open enrollment. I think we all remember the disastrous rollout from last year.

Web site problems, untrained or uninformed navigators, and confusion over the four tiers of plans, deductibles, and subsidies overwhelmed prospective consumers.

Where Are We Today?

First let’s set the parameters. Many people seem to confuse “Healthcare” and “Health Insurance.” The Affordable Care Act, or “Obamacare” as some people refer to it, is insurance — not healthcare.

In order for the act to be successful there has to be enough money received in premiums to allow the private insurance companies to both pay benefits and make a profit.

In order for that to happen there needed to be a sizable number of younger consumers, under age 35, signing up who would be healthy enough not to need much in the way of benefits to offset those coming in with pre-existing conditions.

The non-profit, “Transamerica Center for Health Studies,” is reporting that the goal of the ACA in signing up 35% of Americans under age 35 missed the goal. Only 28% of the target group signed up.

The Free Market To The Rescue

More private insurance companies than expected will be offering healthcare policies through their “state exchanges.” Additional competition did what it always does. Some states saw a reduction in premiums that attracted more consumers.

The thing to keep in mind is this. Every company that delivers any commodity within the healthcare industry is produced and delivered by a “for profit” company.

There are no free tongue depressors.

Who Is Not Insured?

Many healthy, younger, people are deciding to wait and pay their healthcare out of pocket. The fine for not having an approved government healthcare plan is $95 per year or 1% of your income whichever is higher.

You also have to pay your premiums for at least nine months out of the year to avoid the penalty. Plus, paying the penalty does not get you insurance. You would still be uninsured.

For a full time worker making minimum wage in Montana of $7.80 would be $16,224/year, or a fine of $162.24.

The fine for not having insurance increases each year putting more hardship on those who can least afford it.

Twenty-three percent of the uninsured are unemployed versus 7 percent of the total population. Forty-one percent have less than a high school education compared to 27 percent of the general population.

The uninsured have a median household income of $37,300 compared to $67,000 for the general population.

Forty-four percent are between the ages of 18-34 compared to 33 percent of the general population.

Thirty-one percent are Latino compared to 15 percent of the general population.

Some Final Thoughts

According to Real Clear Politics the number who approve of the ACA is 38 percent with 51 percent opposing the law.

There is a big difference between having insurance and insurance being affordable.

In many cases the deductibles and total out of pocket don’t pencil out for many Americans. How’s the ACA working out for you?

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