ACA fight shows nation growing more divided on health care

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Schwarz and Dorsch represent two Americas, pulling farther apart over former President Barack Obama’s health care law. Known as the ACA, the law rewrote the rules for people buying their own health insurance, creating winners and losers.

Those with financial subsidies now fear being harmed by President Donald Trump and Republicans intent on repealing and replacing the ACA. But other consumers who also buy their own insurance and don’t qualify for financial help feel shortchanged by Obama’s law. They’re hoping repeal will mean relief from rising premiums.

The ACA sought to create one big new market for individual health insurance in each state. It required insurers to accept all customers, regardless of medical problems. And it provided subsidies to help low- and moderate-income people afford premiums.

These newly vested ACA customers joined consumers already in the market to make a new insurance pool. Policies offered to all had to be upgraded to meet new federal standards for comprehensive benefits, raising premiums. And many of the new customers turned out to be sick- er than insurers expected, pushing rates even higher.

Consumers who didn’t qualify for government financial help wound up bearing the full cost of premiums. They also faced the law’s new requirement to carry health insurance or risk fines.

“One (group) is angry, and one is incredibly grateful,” said Robert Blendon of the Harvard T.H. Chan School of Public Health. If Trump and congressional Republicans aren’t careful, their actions could stoke fresh grievances without solving longstanding problems of access and cost.