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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

#121

Post by pnutjam »

defen wrote: post #77
tptacek wrote: post #34

Earlier quoted context omitted.

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?

I'm not sure - since I have either option, I don't feel screwed over, but if an HDHP were the only option I would definitely expect to see an increase in take-home pay.

Are you buying a family plan, because I'll bet there is a significant difference in cost to you if you were buying coverage for kids or spouse too.

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

#122

Post by apocalypstyx »

LarryDarrell wrote: post #109
mieseratte wrote: post #72

Earlier quoted context omitted.

I signed up for the ACA the year it came online. Over the years I went from a sub-$100 plan that actually covered things to paying $300+ per month for the "hit by a bus" plan that was so expensive, one year I said fuck it and paid the penalty instead. I understand well what could have been had something truly happened, but I ended up saving money paying the penalty while still having a few minor doc-in-a-box visits o…

It is corporate welfare, I remember lots of libertarian arguments to that very point. But to solve health care in the US you would eventually have to start questioning the for-profit underpinnings of the whole enterprise. That was far too much to expect from the generally pro-market Democrats in office at the time. Even after Bernie Sanders, the "Very Serious Democrats" talk more of protecting the Health Insurance In…

As I once heard it put: the US doesn't have a left and a right party, it has two parties to the left and right of capital.

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

#123

Post by pnutjam »

LarryDarrell wrote: post #60

If you were designing a society starting from scratch today and said, "I think we should make having health insurance largely dependent on having an employer.", you would be laughed out of the room. I think we are running along some tracks that were laid long ago, and rather than all jumping off, some people in comfy Pullman cars are content with letting the train run off a cliff.

to be fair, they think there are wings on their pullman cars. There aren't, but still...

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

#124

Post by symfoniq »

conorh wrote: post #41
rb808 wrote: post #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…

I like it too, except that my (bronze level in the marketplace) high deductible plan is ~$1300 a month for my family, that is not sustainable. A recent ER visit with 1 night stay cost us about 8k out of pocket, the family deductible for the plan is $13k a year.

Sounds like we are on the same plan.

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

#125

Post by refurb »

tptacek wrote: post #113
mieseratte wrote: post #72

Earlier quoted context omitted.

I signed up for the ACA the year it came online. Over the years I went from a sub-$100 plan that actually covered things to paying $300+ per month for the "hit by a bus" plan that was so expensive, one year I said fuck it and paid the penalty instead. I understand well what could have been had something truly happened, but I ended up saving money paying the penalty while still having a few minor doc-in-a-box visits o…

If you're saying the ACA didn't completely fix the US healthcare system, I strongly agree. If you're saying the ACA harmed the health care system, strong disagree. Again: the cost increases you're talking about were a fact of life before the ACA. There is no evidence that your costs would have leveled off without the ACA, and substantial evidence that the opposite would have happened.

The increase in costs were most certainly driven in part by the ACA changes. No longer allowed to deny based on pre-existing conditions? Insurers need higher rates to cover those costs. Require a bunch of things be added to mandatory preventive visits? Those have to be paid for as well.

That said, I agree the costs would have continued to go up, but to say there is no evidence that the ACA contributed to it is just ignoring the math.

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

#126

Post by briffle »

LarryDarrell wrote: post #60

If you were designing a society starting from scratch today and said, "I think we should make having health insurance largely dependent on having an employer.", you would be laughed out of the room. I think we are running along some tracks that were laid long ago, and rather than all jumping off, some people in comfy Pullman cars are content with letting the train run off a cliff.

I find it odd that some executive gets to pick which 401k and health insurance plans you get, and that you must pick from their few choices that allow you to have. I can see why the providers love it, they can target all their advertising, marketing, etc, at a few key people at large employers, but not sure how that benefits the average worker..

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

#127

Post by [deleted] »

tptacek wrote: post #38
mrosett wrote: 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.

[deleted]

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

#129

Post by kxyvr »

lotsofpulp wrote: post #116
kxyvr wrote: post #101

Earlier quoted context omitted.

This is not to say that you're wrong, but I don't completely understand your numbers. My understanding of the triple-tax advantage of HSAs are that 1. Money going into the HSA is pre-tax 2. Investment gains from the HSA are not taxed 3. Money used from the HSA for qualifying health expenses is not taxed That said, there are many restrictions and two of these benefits seem to be included for self-employed individuals.…

If you save your receipts for any medical care you or anyone else has received that you paid for, you can withdraw from your HSA to "reimburse" yourself at any point in time, including the future. Q39 at bottom of page 18 of following IRS document: https://www.irs.gov/pub/irs-drop/n-04-50.pdf Have a baby? Save that receipt showing payment for $5k from your post tax dollars, and let the money in your HSA grow tax free…

Alright, if I understand you correctly, you're essentially using the HSA kind of like a Roth IRA, except that

1. Money contributed is tax free

2. There is a $3.5k contribution limit

3. Money can be withdraw tax free prior to 65, at any time, as long as there's a receipt for the qualifying medical expense that occurs after the HSA was established

Then, from what I can tell, the drawback to this approach is that there needs to be enough cash flow to cover for medical expenses. Certainly, money could be withdrawn from the HSA, but the real tax benefit comes from pretax contributions and that capital gains, interest, and dividends are tax free. Overtime these can provide a huge amount of savings, but they need time to develop. Sound about right?

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

#130

Post by lotsofpulp »

mrosett wrote: post #11
tathougies wrote: post #6

Earlier quoted context omitted.

The point was that the premium was lower so you could save the difference and instead of that difference going to waste each year, it could compound over time.

HSAs aren't use it or lose it. That's FSAs.

tathougies was referring to the difference in monthly health insurance premiums. I don't see what their comment has to do with Flexible Savings Accounts.
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