(Statements) about increased deficits, taxes and rates are common and based on misinformation about the ACA and pricing dynamic.
This is a really simple explanation but most people in our state (Mississippi) will not even try to understand what they are dealing with. Perhaps you will understand it, but this is how the ACA was formulated by people that know both the constitution and the health care system much better than us rednecks do.
We pay for defaults through increased medical care prices, and that is the main problem. They are killing us quicker than taxes or deficits, so if they show up as taxes or price hikes or deficits they still would be showing up. ACA costs are not like ordinary government spending in that respect. You are going to pay one way or the other. The folks that call this a big tax hike "forget" to remind you of the honest truth on that point. You're already being taxed by medical costs twice as high as they should be.
So the ACA seeks to do several things and one of them is to make sure the price hikes can be slowed, and that happens with the insurance requirement. Those bills get paid instead of making costs higher through defaults.
The insurance requirement also comes with a provision for more fair coverage, pre-existing conditions, and that also stops defaults -- patients without insurance -- going for major work and then defaulting. That is because when a patient is denied and just goes to the hospital and defaults or gets a super discount, you pay for that in price hikes. That is another way the insurance companies duck the liability and you get screwed with higher prices.
Insurance costs go up when the preconditions are part of the insurance system upon implementation of ACA -- but before, they showed up as price increases upon default, so that is a wash that also makes sure preventative care comes to those people, and that reduces cost.
There are no provisions to stop access to doctors, except that the people who would be avoiding it, getting really sick, then going and defaulting would be able to see doctors more easily for preventative care. If that creates a problem, the market will respond with more doctors. The market will not be dead.
Interstate competition in health care might lower prices marginally but it would require the creation of a new bureaucracy to manage the interstate and that would be federal. The reason it is handled now at the state level is because those state's rights nuts thought it could be better handled by state government, and that leads to what we have now. The idea that simply creating a different monolithic bureaucracy on the federal level does not offer the promise of significant savings. But the largest and most powerful national and international corporations favor this approach because it would stomp smaller companies. Truth is, local insurance agents at least make some money now and are underwritten by larger corporations anyway. A new interstate system would just mean your cousin Charlie lost his job in Jackson and would have to move in with you, and a phone bank in New Delhi would get a lot of Charlie's work.
Free enterprise sounds great but it is a baldfaced lie. The Founders allowed for the destruction of free enterprise with the patent system, whereby an idea can be claimed and the government makes sure nobody competes with you. There are about a thousand laws that do the same things, and when it comes down to it everybody gets their crony laws, but "free enterprise" means the common man does without this protection. That is the gospel truth -- to keep our markets alive we have to realize that and balance the protections.
Hope that helps. I have done my homework on this, but I know most folks here have not even looked over the law and (instead) let themselves be informed by politicians or talk radio idiots. That is a serious mistake.