A recent Kaiser Family Foundation poll revealed that just under half of Americans (47 percent) expect increased debate over Obamacare now that Republicans control the Senate. So, what should Congress do next about the new national healthcare system? Based on that same poll, that’s not an easily answered question: 29 percent of Americans support repeal of the law; 22 percent wish to expand the law; 20 percent support moving ahead with ACA as is; and 17 percent wish to scale back the law.

While answers may be confusing one thing is crystal clear. There’s a striking new trend in healthcare insurance: paying directly for services.

Once Patients, Now ‘Consumers’

“Consumers are seeing more and more of the costs directly,” said Avik Roy, senior fellow at Manhattan Institute for Policy Research. Speaking at the Forbes Healthcare Summit 2014, Roy said consumers are “paying more of the premiums for their employer-sponsored insurance, and they’re seeing more of the co-pays, while deductibles are higher.”

Others speaking at the Summit agreed with Roy’s view, including his belief that Obamacare is accelerating this trend. “Three quarters of my employees are in high deductible plans,” said David Goldhill, President and Chief executive officer, Game Show Network, adding that two thirds of employers say they will switch to high deductible plans if only to avoid the impending Cadillac tax — scheduled to take effect in 2018, this 40 percent tax will be applied to employers who do not provide cost-effective plans.

“A significant percentage of consumers are direct buyers of their healthcare — it’s effective catastrophic care,” said Goldhill. “That‘s a sea change.” He predicts that, if the average person is paying directly for their healthcare, “the way they think about their insurance plan changes, and the way providers have to address people changes.”

User Experience and Insurance

Clearly, many have already heard the call, including Kevin Nazemi, co-founder and co-chief executive officer of Oscar Health Insurance. In particular, he is critical of the current user experience for healthcare insurance — have you ever received an explanation of benefits, which is anything but? In response, Nazemi focuses his company’s efforts on the “usability layer” of insurance, with a website that helps you use “technology to guide you to better care and help you keep track of your health.” Meanwhile the Oscar plans offer free telemedicine, free generic drugs, and online price comparisons — new additions to the usual services.

Another entrepreneurial take on the same dilemma comes from Lisa Maki, a former Silicon Valley denizen who is CEO of PokitDok, a platform for business and health. PokitDok is “everything that you need to support a real-time, retail experience” when purchasing health services, Maki says. To illustrate her product, she offers the example of someone with a high deductible plan who needs an MRI.

“I’d like to go out, and get a quote and see what it will cost me at all my local healthcare providers,” Maki explains. “Pockit doc will get you that quote, let you book it, and pay for it upfront.” All physician information is validated by the American Medical Association, while treatment, services, and pricing data are derived from the practices themselves as well as other sources.

So while Congress sorts out the policy side of Obamacare, technology professionals are bringing to market appropriate fixes for the practical side of the law. For many, these fixes could be as life-saving as their actual medical care. Nearly five percent of cancer patients declare bankruptcy, noted Peter Bach, the Director of Memorial Sloan Kettering’s Center for Health Policy and Outcomes, at the Forbes Healthcare Summit. A key Obamacare question is: Will that number grow or decrease in the coming years?

Correction: A previous version of this article incorrectly capitalized "PokitDok," and did not identify the source of data.