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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

#131

Post by lotsofpulp »

SilasX wrote: post #10
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.

From what I understand, even the HDHPs have such high premiums that the point is not being achieved, especially if you have to go through the marketplace rather than the employer.

Due to rising healthcare costs, and employers reducing the portion of health insurance premiums that they want to pay for their employee (aka a paycut), that's going to be true regardless of HDHP or not HDHP.

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

#132

Post by BeetleB »

sithlord wrote: post #57
tptacek wrote: post #38

Earlier quoted context omitted.

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.

In my previous career, I was an accountant, and I worked for a health insurance company, you are straight up uniformed if you do not think that ACA raised the the cost of insurance. With that said, as a type 1 diabetic, without ACA it would be impossible for me to get insurance outside of employment, so i think there is some good in it, just needs to be actually thought through, unlike what the administration did tha…

Anecdote, but the two years pre ACA my premiums went up about 9% each year. After ACA it was about 6% each year. Pre ACA my employer said "Sorry. Premiums went up from insurance companies." Post ACA employer said "Blame Obamacare."

Employees being people bought the "Obamacare made my premiums go up!"

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

#133

Post by mrosett »

Someone1234 wrote: post #89
mrosett wrote: post #51

Earlier quoted context omitted.

That's just not how it worked with employer insurance. Perhaps they could drop your whole company, but the insurer couldn't unilaterally cancel a single employee's plan.

I know someone who pre-ACA had employer insurance who was dropped by that insurance after they got skin cancer. The official reason was lying during the application process (10+ years earlier). They forgot to list childhood Asthma on their application form ten years earlier.

Would the ACA prevent that kind of scam? I genuinely don't know.

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

#134

Post by [deleted] »

bradstewart wrote: post #82
jandrewrogers wrote: post #54

Earlier quoted context omitted.

The cost to employers of very good plans massively increased after ACA went into effect. When this changeover happened, I was running a company where we paid 100% for one of the best healthcare plans available in the state for both the employees and their families -- people really appreciated this benefit. This was the polar opposite of a "crappy plan", and it wasn't inexpensive to begin with. After the ACA, this pla…

This happened with my employer as well. And this is/was before the "Cadillac tax" came into effect (I believe it's been pushed back to 2020 now).

[deleted]

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

#135

Post by lotsofpulp »

loeg wrote: post #111
kasey_junk wrote: post #53

Earlier quoted context omitted.

There is no requirement for your employer to provide the HSA. Frequently the employer can get better deals on the HSA than you can individually (like no waived maintenance fees and the like) but you can for sure open your own. In fact once you have enough money in there that you are moving out of liquid investments then you definitely want to shop around for HSA much like you would for an investment account.

Can you actually fund a non-employer HSA with tax-deductible funds, or is that a benefit that only applies to payroll HSA contributions? If not, a lot of the benefit of an employer HSA disappears. (FWIW, I have an HDHP, employer HSA, and an individual HSA that I roll my employer funds to annually for lower-fee investing.)

Yes, just submit a form 8889 when filing taxes.

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

#136

Post by maxxxxx »

lotsofpulp wrote: post #115
maxxxxx wrote: post #107

Earlier quoted context omitted.

are you saying that if your employer offers a high deductible plan without HSA you can open one for yourself? I don’t think many people know that.

Yes. https://www.fidelity.com/open-account/all-accounts (best option, it's free and has access to great investment options) https://healthaccounts.bankofamerica.com/individuals-familie... I'm sure there are others. Edit: In fact, the employer's HSA custodian (unless it's Fidelity), probably charges you a few basis points for investing your HSA funds, so it's actually much better for you to transfer the funds out into…

Good to know!

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

#137

Post by civility »

bliblah wrote: post #67
sithlord wrote: post #57

Earlier quoted context omitted.

In my previous career, I was an accountant, and I worked for a health insurance company, you are straight up uniformed if you do not think that ACA raised the the cost of insurance. With that said, as a type 1 diabetic, without ACA it would be impossible for me to get insurance outside of employment, so i think there is some good in it, just needs to be actually thought through, unlike what the administration did tha…

>> just needs to be actually thought through, It's impossible because you both political parties want exclusively mutual results You can't have cheap insurance without making it mandatory since only the sick will get it You can't have easily accessible insurance without forcing healthcare companies to comply with new regulations forcing them to increase costs You can't have good insurance if you aren't willing to pay…

> You cant lower costs in the US without having a more aggressive regulatory body which 50% of political bodies strongly oppose alongside lobbying efforts

Here is the fundamental problem from my point of view. Compare human medical costs to veterinary costs. Yes, people expect a slightly higher standard for themselves than they do their animals, but you can get a major knee surgery for your dog for a small fraction of what they charge for humans. The process is performed in a sterile environment by professionals in either case. We're smarter than animals on average, but our bodies and medical needs aren't vastly different.

The problem is price gouging because the providers and insurance companies know we have no real ability to shop around. They conspire with each other to publish false rates when the true costs are much lower after you agree to them.

You could maybe solve this with regulation on prices (a socialist approach), but you could also solve it by mandating they advertise true prices and re-enable competition (a capitalist approach). Either way could fix this, and the problem is corruption (lobbying) not party ideology.

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

#138

Post by lotsofpulp »

kxyvr wrote: post #129
lotsofpulp wrote: post #116

Earlier quoted context omitted.

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…

Correct. There's a higher contribution limit ($7k in 2019) if you have family HDHP coverage. Also, after retirement, money can be withdrawn without paying the 10% penalty and just paying the regular income tax, in case you don't have receipts for medical payments from the past.

I wonder how the IRS would prevent a tax evader using the same receipts for payments for medical expenses for different withdrawals in different years.

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

#139

Post by fzeroracer »

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…

My family went bankrupt because the insurance companies decided my mother having a stroke and falling down the stairs constituted a pre-existing condition.

I don't think people understand how pervasive the usage of pre-existing condition bullshit was used to deny payment.

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

#140

Post by lotsofpulp »

trynewideas wrote: post #105
rockinghigh wrote: post #65

Earlier quoted context omitted.

Anyone with an HDHP plan can get an HSA. Whether it's through your employer or through another plan provider like Fidelity or Vanguard.

An HSA with no employer contribution, or even administrative assistance, is like throwing money into a trash can, except at least if you throw money into a trash can, you can wheel it down to any hospital and they'll probably accept it.

What? It takes 5 minutes to open a free HSA account at Fidelity and transfer funds to it.
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