The poor and elderly in the US have government paid healthcare already in medicaid and Medicare. Children are also covered under medicaid unless their parents make a certain amount of money. These programs are rife with waste and fraud, and extremely expensive, with the costs rising each year way faster than the cost of living. People are afraid that with the existing trillions of dollars of debt we have no way of paying back that increases every day, with decreasing revenues because of long- term high unemployment and businesses going bankrupt, that adding healthcare for everyone to that mess is so fiscally unsound as to be dangerous to the health of the economy. If the economy tanks, there won't be money even to help the very poor, sick, young, handicapped, and elderly who cannot care for themselves. There then won't be money to help the poor and ill with even food or shelter, never mind a mammogram.
The US has always been a nation where taking care of yourself and being independent are cherished values. We pull ourselves up by our bootstraps and work hard for what we have, and help those less capable. In addition, this particular bill requires everyone to have and pay for health insurance, even young healthy people. Americans do not like being told they have to purchase something because the government says so, and it has never happened before this bill was passed.
Yes, if you are poor AND elderly, or if you're poor AND have minor children, or if you're poor AND disabled, you have access to Medicaid. That leaves out wide swathes of the population, including poor adults w/o minor children (and "poor" means really poor - the poverty level for a family of four is an annual family income below $23,000 as of the last time I checked).
And frankly, if you're lower middle class, you're not going to be able to afford insurance if you aren't lucky enough to be employed by an employer who provides group insurance. Even if you're upper middle class, you're not going to be able to get insurance if you have a pre-existing condition.
I'm about as physically healthy a specimen as you are likely to find, but I took anti-depressants for years. The last time I came off a group plan, the Health Care Portability Act had been enacted, so insurance companies had to sell me insurance after I used up the COBRA coverage. The
monthly premium for just major medical with the maximum levels of co-pay was more than $5,000, and it didn't matter whether I waived psych coverage. Tell me who can afford to pay $60,000-$70,000 per year in premiums for major medical coverage?
I haven't had a mammogram or a pap smear in years - there's no point, because if I found out I had cancer, I couldn't get treatment. And I'm not an unusual case by any means.
The people who have been most severely impacted by the healthcare system in this country are working people. All the crap about Americans pulling themselves up by their bootstraps is what people who have been fortunate enough to find themselves covered by group coverage tell themselves to make themselves feel better.
As to people being forced to buy insurance - the only way in which it becomes feasible to provide coverage for people with pre-existing conditions and not drop people if they become chronically ill is to also have the healthy people in the pool - that's what group coverage does in effect - it averages out costs between people who need medical care at any given point and those who don't.