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Employees Start to Feel the Squeeze of High-Deductible Health Plans

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Re: Employees Start to Feel the Squeeze of High-Deductible Health Plans

#31

Earlier quoted context omitted.

Not all employers offer HSAs to go along with their HDHPs. Mine doesn’t and it’s very frustrating. I want to save pretax money in an HSA but I can’t.

Can you just open your own HSA account and do it yourself?

Short answer: generally, yes

Re: Employees Start to Feel the Squeeze of High-Deductible Health Plans

#32
post #4

Isn't the point of an HDHP that you're supposed to set up an HSA to go with it? Premiums for HDHPs are significantly lower than for normal health plans; the idea is that you're supposed to use the premium savings to fund the HSA, which is then money that carries over year over year, right?

I think the value of this really depends on the employer. At a previous role they started switching to an HDHP with an HSA and did a great job (initially) making that fairly attractive versus the low deductible plan with higher premiums.

At my current employer, the deductible per person is close to $4000 and the family limit is ~$10K. The employer provides some money if you have an HRA, but very little if you take the HSA. The premium savings from the low deductible plan (which isn't available any longer) really doesn't make up for the higher deductibles. All it takes is one small series of events (e.g. a complicated pregnancy) for $10K to go out the window. If these series of events happens from December - January, that's 2 years of deductibles out of your pocket.

I work for a huge company and I'm surprised the insurance is so expensive. For the first time in my life I think one of major criteria of my next job will be the healthcare benefits. Previously I was just happy to have insurance - no longer.

Re: Employees Start to Feel the Squeeze of High-Deductible Health Plans

#34
post #25
post #4

Isn't the point of an HDHP that you're supposed to set up an HSA to go with it? Premiums for HDHPs are significantly lower than for normal health plans; the idea is that you're supposed to use the premium savings to fund the HSA, which is then money that carries over year over year, right?

If it's an employer-provided plan, though, you don't generally see the premium savings. My employer provides the option (through one of the major payroll/HR providers) of a "regular" plan or a high-deductible plan, but neither choice affects my take-home pay. I still chose the HDHP though because I'm generally healthy and it lets you invest pre-tax money with no capital gains tax, which is nice.

Ok, so then, the nut of this story is that employers are adopting HDHPs as a way of reducing their own costs, but not passing the savings to employees, which defeats the purpose of HDHPs and just amounts to screwing employees over?

Re: Employees Start to Feel the Squeeze of High-Deductible Health Plans

#35
post #4

Isn't the point of an HDHP that you're supposed to set up an HSA to go with it? Premiums for HDHPs are significantly lower than for normal health plans; the idea is that you're supposed to use the premium savings to fund the HSA, which is then money that carries over year over year, right?

Not all employers offer HSAs to go along with their HDHPs. Mine doesn’t and it’s very frustrating. I want to save pretax money in an HSA but I can’t.

That’s the insanity of employer health insurance. Things like this should never be a decision of the employer. It’s the same stupidity with 401k.

Re: Employees Start to Feel the Squeeze of High-Deductible Health Plans

#36
post #8

High-deductible health plans were always designed to benefit employers. My company switched us to one with a big PR campaign highlighting how everything would be better (contributions to HSA - free money!). The only "advantage" is that companies have to pay smaller premiums and employees are greatly discouraged from getting care due to high costs. Funny enough, employers are rethinking this now since employees not ge…

Obamacare also added an extra tax on the best health insurance. The problem when no one has to pay anything is that people don't care about price.

> an annual 40% excise tax on plans with annual premiums exceeding $10,800 for individuals or $29,500 for a family starting in 2020 (delayed further)

https://en.wikipedia.org/wiki/Cadillac_insurance_plan

Re: Employees Start to Feel the Squeeze of High-Deductible Health Plans

#37
post #3

Earlier quoted context omitted.

How so? The choice of covering crappy plans is the employer's choice... and crappy plans are what have been pushed AFTER the ACA was passed. Largely by the GoP... Is that what the ACA was, or what someone(s) who want it to fail want? There's a weird narrative where any event is tied to the ACA while they ignore what the healthcare system is in the US overall.

The parent comment is exaggerated, but I think the point is that prior to ACA, employer-provided plans tended to be cheaper and have lower deductibles largely because insurance companies were able to drop or deny coverage whenever they felt like it for individual plans to keep their margins up. While logically true, this is roughly equivalent to hearing from an old coworker that South Africa was a great place to be w…

It's more extreme than your example. The parent is ignoring the fact his great healthcare experience is predicated on them being able to drop him the moment they could, when his illness became too expensive.

Ending pre-existing conditions was the game changer in the AMA. Treating people is obviously more expensive than not treating them.

Re: Employees Start to Feel the Squeeze of High-Deductible Health Plans

#38
post #2

You can argue that the ACA improved the healthcare system overall. But it's been tough for people who were already covered by employer insurance. I think people fail to appreciate that prior to the ACA, when the healthcare system worked, it actually worked really well. I got very sick at the age of 20 while I was still on my parents very modest insurance (pre-ACA). Within 48 hours I had an appointment at the best onc…

I'm not seeing the connection to the ACA in your argument. If your argument is that the ACA raised the price of health insurance, that's incorrect: health insurance premiums had been skyrocketing prior to the ACA (that crisis was what generated the political capital to pass the bill), and the ACA in fact reduced the rate of growth in health care costs.

Re: Employees Start to Feel the Squeeze of High-Deductible Health Plans

#39
I really like the idea of high deductible plans. The idea for me is that insurance shouldn't cover regular costs that most people pay every year. Insurance should just be for unusual events, like car insurance is only used if you have an accident.

So now I got a $2k bill from ER for something that wasn't really an emergency. It makes me think carefully about next time this happens where before the cost didn't really affect me. Changing people's behavior is important part of reducing costs of the health care industry.

EDIT: Yes I'm not happy with how expensive prices are now. That is the problem that HD plans have.

Re: Employees Start to Feel the Squeeze of High-Deductible Health Plans

#40
post #3

Earlier quoted context omitted.

How so? The choice of covering crappy plans is the employer's choice... and crappy plans are what have been pushed AFTER the ACA was passed. Largely by the GoP... Is that what the ACA was, or what someone(s) who want it to fail want? There's a weird narrative where any event is tied to the ACA while they ignore what the healthcare system is in the US overall.

The parent comment is exaggerated, but I think the point is that prior to ACA, employer-provided plans tended to be cheaper and have lower deductibles largely because insurance companies were able to drop or deny coverage whenever they felt like it for individual plans to keep their margins up. While logically true, this is roughly equivalent to hearing from an old coworker that South Africa was a great place to be w…

Yes: if you go back in time, health care costs go down, because they've been rising rapidly over the past 20 years. But the only thing that happens at the point in time when the ACA passed is that the rate of growth in cost falls.
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