Time for an update, I guess.
I now live in Florida (short story: divorce, happy remarriage). We have a Republican governor who has chosen to opt out of Obamacare. So no health exchanges. No Medicaid expansion.
Obamacare would cost me $760 a month. A non-approved healthcare plan that covers 60% of hospital costs and no outpatient medications costs me about $250 a month. Even with the Obamacare fine, it's still cheaper than the Obamacare price.
So I'd say that Obamacare, at least for me personally, is a bust.
Compare this to what I really want, which is catastrophic, high-deductible health insurance that would pay for at least 90% of hospitalization but no outpatient meds. That used to cost $1,000 a year, less than $100 a month. But Obamacare outlawed that. Now, you can only buy Cadillac plans that offer a checklist of superfluous services.
Obamacare is looking more and more to me like a sop to the Big Four private insurance companies: United, Blue Cross, Humana, and Aetna.
I wouldn't mind replacing it with a Single Payer. I still think giving the VA back to the PHS would be the cheapest way to take care of the most people, with the best hope for quality improvement.
I so hate monolithic, unaccountable monopolies. I far prefer competition. I was all for a huge private sector (taking care of 250M Americans) competing with a significant public sector with 50M patients. But Bernie Sanders is unshakeable in his belief in a Single Payer, and I haven't been able to persuade any of his Legislative Assistants that it's a bad idea, politically as well as medically.