"Ian. Here is the problem. You sign up and your exchange co-op entity defaults. What happens? In the real world, you are now SOL. I dunno, just asking."
I don't know either. I have opinions and assumptions but this isn’t my area of expertise.
Here's a real world scenario. I know of a young girl (mother is a childhood friend of my wife) who was diagnosed with cancer. Her father is a small business owner and before the diagnosis, was paying an arm/leg for health insurance for his family.
The bill for her first round of chemo, which was supposedly covered by his health insurance, was ~ $80k. The insurance company refused to pay the bill with no explanation. It took many months, many calls to political representatives, and extra undue stress above and beyond the nightmare of having a sick child to resolve the issue.
Will ACA or a future single payer system fix this problem? I can't say but after hearing their story, it's difficult for it to get much worse in my mind using our pre-ACA model.
I've said it before; I wouldn't have signed off on ACA as written but I wish it success. Our system is broken and hopefully this will be a step in the right direction.
Here's her blog if you're interested in following her story:
Doesn't talk about the insurance aspect of it but a neat kid and story nonetheless.