The ACA is about as close to universal healthcare as you can get. That's why it cost so much. If we had actual universal healthcare as some other countries do, it would cost even more, and the quality of healthcare would plummet. You can ask residents of those other countries who come to the USA for healthcare all about it. The long wait times are enough to cause them to come here where it's not universal, but higher quality.
You apparently don't know anything about universal healthcare if you think the ACA somehow resembles it. This post is objectively wrong.
Universal Healthcare:
Covers everyone, regardless of income, employment, pre-existing conditions, or age.
Single system ensures no gaps in coverage.
ACA:
Expands coverage but does not cover everyone.
Many people still rely on private insurance or fall into gaps in Medicaid eligibility (especially in states that didn’t expand Medicaid).
Coverage is often tied to employment or eligibility for subsidies.
Universal Healthcare:
Typically government-administered (single-payer) or heavily regulated multi-payer system.
Government negotiates prices for hospitals, doctors, and drugs.
ACA:
Relies on private insurance companies.
Government sets rules and provides subsidies, but does not control hospital, doctor, or drug prices.
Universal Healthcare:
Uses centralized negotiation to control costs for services, medications, and procedures.
Administrative costs are low due to one system handling billing and claims.
ACA:
Does not regulate provider prices, so costs for premiums, deductibles, and medical services remain high.
Administrative costs stay high because multiple private insurers and billing systems are involved.
Universal Healthcare:
Funded by taxes (federal and sometimes state), rather than premiums alone.
Individuals do not pay separate premiums for essential coverage.
ACA:
Funded by premiums (from individuals and employers) plus taxes.
Subsidies help lower-income people afford premiums, but middle- and upper-income people often pay more out-of-pocket.
Universal Healthcare:
Entire population is pooled, so risk is spread across everyone.
People cannot be denied coverage, and coverage is lifelong.
ACA:
Risk is pooled within insurance markets, not nationally.
People can still face high deductibles, copays, and gaps in coverage if subsidies aren’t enough.
Universal Healthcare:
Simpler: one system handles enrollment, billing, and reimbursement.
Less paperwork for patients and providers.
ACA:
Complex: multiple private insurers, different plans, marketplaces, subsidies.
High administrative overhead, confusing enrollment, and claim disputes remain common.
The ACA is vastly different than universal healthcare. Hence why universal healthcare is cheap in every modern nation that uses it, while the ACA is not.
