There is no perfect solution to covering everyone's healthcare needs. We are where we are, but a better mechanism might be transferring the money directly to the people who need the help under our current system, and requiring them to have health insurance by installing an individual coverage mandate with actual teeth.
The tax credits will be provided on a sliding scale. For example, a four-person family purchasing a $15,000 family insurance plan in 2014 with $60,000 in annual income would receive tax relief of approximately $10,200. A similar family with annual income of $35,000 would receive tax relief of about $13,600.
So why not just write them a check from the Treasury to cover the shortfall? Then, people have the incentive to actually shop for a healthcare plan that works for them and pocket the difference, if there is any. Before you ridicule this approach, the current plan is not simply accounting paperwork. Treasury will still be issuing checks to someone, or something. Guess who?
Under my proposal, there still would be the problem of protecting people from dishonest health plans that give the impression of coverage but don't pay out when disaster strikes, but we have that problem now, and will likely still have it under the current tax credit plan. Besides, PPACA, in addition to covering the uninsured, was supposed to be about solving the systemic problem of healthcare cost inflation. In short, it won't.
And guess what else? Getting the federal government to sign off on 10% annual increases in healthcare cost inflation is much easier than getting savvy consumers to do the same thing. Makes you wonder whether they did all this with that cynical thought in mind, doesn't it?