Health care costs were screaming out of control long before The affordable healthcare act came along. Our healthcare costs in the IBEW were doubling every couple of years during the 2000's and we were self insured.
No not really, for the self insured we had choice, we could pick plans that did not have pregnancy coverage, mental health, dental and they were affordable with $1000 deductibles, and I was never denied coverage....ever. Now we have automatic mental health, pregnancy even if you have a hysterectomy, dental, but no body under age 18 can use it, free physical that cost the insurance $1000, it was $ 50-100 under the old plan, free eye test every year, free diet consulting.....for everyone, and we wonder why the price tripled. I can also tell you my father died of cancer under my old plan, the price of coverage went from $8000 a year to $12000, but he never was refused any services, and after he was in the ground they paid every single bill, every penny, over a half million, and the next year the premium dropped back down to $8000. At that time my policy covered 4 adults and 4 children , now 30 k covers 3 adults with high deductible, and I bet they will refuse a lot of services. The old plans were fantastic for us. I know of the cry stories where people were bankrupted back I the day, in every case they missed a payment or had no insurance. The key back then was to have insurance before you were sick and pay the premium no matter what.