Working in a hospital billing office has opened my eyes to this sad fact . You can go to the hospital for something fairly minor and end up with a $ 1000 bill . If you have insurance , it ' s almost all paid for , minus your copay or deductible of $ 100 or whatever . You come out thinking , whew , thank goodness I had insurance to cover that other $ 900 . But that ' s not what happened . What happened is the hospital had to adjust the bill down to $ 150 due to contractual obligations with your insurance company , then your insurance paid $ 50 while you paid $ 100 , and still spend $ 100 month on your premiums . If you ' d had no insurance ? Sorry , you owe the full original $ 1000 bill . It ' s absolutely rigged against poorer people who can ' t afford insurance . Obamacare tried to remedy this exact situation , giving people at or below the poverty line a chance to afford insurance so they could get those adjustments on bills , and it ' s a shame to see the political establishment convince the very people Obamacare helping that it is in fact hurting them .