Well take my own case for example. I'm self employed in my own little one-man business. Up to a couple of years ago I shared my wife's insurance from her work, but then she got breast cancer and had to go on disability. She gets Medicaid because she's 'disabled', and I went off to find my own insurance.
I got offers from the 4 or 5 companies that sell health insurance in California, and they were all about the same. It's $750/month, just for me. I could afford that (it would be a hardship), BUT that $750 a month also has a $4500 yearly deductible, so I end up paying for whatever health care I actually get. And if I get 'lucky' and have a heart attack or cancer and pass the deductible amount, they pay HALF.
So I remain uninsured. I'm not poor enough for Medicaid, not rich enough for insurance.
I was really counting on the Public Option but the Republicans killed it. There was no real reason to kill it. It would have been paid for entirely by the customers, not cost taxpayers anything. If it worked, if it was cheaper or better than commercial insurance, commercial insurance would have come down or people would leave. If it was worse, it would have died a quiet death as people just left the system. But we'll never know, now will we?
As it is, I will have to wait for Medicare. If I have a heart attack or cancer or a car accident between now and 65, I'll have to declare bankruptcy and the American People will pay my medical bills. (After I lose my IRA).
We don't just let people die, that's the thing. Republicans think poor people who get sick should just go curl up and die somewhere. But we are a civilized country, nobody bleeds to death on the steps of the ER. They HAVE to treat you, to an extent, whether you can pay or not. The hospital makes it up by charging insured patients more. Ever wonder why a tylenol in the hospital costs $25?