Also, hard working people, many small business owners do not qualify for government insurance, such as Medicaid, and have huge cost co-pays with health exchange insurance offered through the ACA. Therefore, these same people are afraid of incurring a large debt that would damage their credit and future livelihood (Kuntze, 2008). By comparison, an act utilitarian would see the above example based on a case-by-case situation while many have benefited from the ACA, others have still found themselves in a difficult financial situation, not really benefiting from the new health care law ( Hartwig,