Don't worry, it will go in a single payer direction as more providers ditch the marketplace.
As to the Medicaid funds, when the Fed. gov't ditches their portion of that funding, the states will have to find a way to increase payments to it to make up for that loss - assuming their numbers don't grow and at least maintain.
But because of the income limits, there are always going to be people left out of it and will not have health insurance because of it. What I don't like about the ACA, is the fact that I was perfectly insured before hand. I fall into that damned loophole where either I pay in full myself, or I just don't get health insurance (this is mid-surgery, so I'm kinda stuck and really pissed). Since the ACA has gone into full effect, my insurance costs are now 200% of what I was paying before. I can't afford it. If we put my husband on the plan we'd be paying around $700 for 2 people, whereas prior we'd be paying around $200-300.
The thing I really don't like, is the fact that if Medicaid had been expanded I'd be forced to it, when I was just fine operating without gov't assistance. On top of that, Medicaid isn't free money. In most states, it operates as a loan - as do most gov't programs if you're in a position to move up the economic ladder. If you use more than you've paid in, they will come after you or your estate at a later date to recoup as much of the costs you've incurred as possible. Why should anyone be forced into that kind of debt to the gov't?
