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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

#171

Post by sanderjd »

mieseratte wrote: post #161
apocalypstyx wrote: post #122

Earlier quoted context omitted.

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.

I heard it once said that America is a one-party system, but in typical American excess we have two. Both in service of capital.

I used to dabble in enjoying quips like this. They're simple and fun and sound insightful and knowing. But when I look around me I see no truth to them. We have two parties with very distinct philosophies making very different arguments for how the future of our culture and economy should function. "Capital" influences both of them, in different, sometimes overlapping, ways. But they have many differences across many axes.

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

#172

Post by ixwt »

etchalon wrote: post #95

At Mess (my agency), we were sort of forced into going with a HDCP, but we found a way for it to be a win for everyone. Our absolutely-perfect no-deductible no-coinsurance plan was retired, and every year, for five years, the cost of our reasonable-deductible no-coinsurance plan kept going up. Eventually, our broker convinced us that HDCP was the only way. But I absolutely hated it. We have quite a few employees with…

My company did something different. They couldn't negotiate a decent price to keep the already bad $X deductible (which wasn't terrible, but was still classified by the IRS as a HDHP). We have a lot of young people who don't even hit the deductible as it is.

So, their compromise was to get a plan with a $2X deductible. BUT they reimburse you for any penny spent over $X before the deductible has been payed. The reimbursement if handled by another company, so the company I work for never sees any medical information.

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

#173

Post by tathougies »

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.

I mean, if a HDHP plan costs 400 / mo and a regular plan costs 1000 / mo, you get to save the 600 and let that compound over many years (if you don't use it), rather than lose the 600 in insurance premiums.

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

#174

Post by tathougies »

lotsofpulp wrote: post #130
mrosett wrote: post #11

Earlier quoted context omitted.

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.

yup!

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

#175

Post by rayiner »

jseliger wrote: post #69
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…

But it's been tough for people who were already covered by employer insurance. Yes. The only word I disagree with in the headline is "start." The squeeze started years ago. One way to look at the problem is this way: http://seliger.com/2018/11/11/health-insurance-security-fqhc... : In Northern Virginia, for example, the cheapest 2019 Obamacare individual market Silver plan for a family of four (mom and dad age-40) ma…

At least that premium is totally reasonable. In Germany, the health insurance tax is 15%, half paid by the employer and half by the employer (and it’s not progressive like the ACA subsidy). $4,500 per year is 7% of income, lower than what the employer-side tax alone would be in Germany.

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

#176

Post by mikestew »

frenchman_in_ny wrote: post #160
WrtCdEvrydy wrote: post #108

Earlier quoted context omitted.

My favorite one was pregnancy being a pre-existing condition so if your husband got fired (noone would ever fire a pregnant woman for no reason), you couldn't get insurance when you needed it the most.

Though ( if both spouses were working & had access to employer sponsored insurance), wouldn't the husband being fired result in a qualifying change for the woman, allowing her to enroll on her employer's insurance plan, thus covering the pregnancy?

Or COBRA, unless you expect your pregnancy to last longer than 18 months.

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

#177

Post by mattlondon »

rayiner wrote: post #167
pnutjam wrote: post #71

Earlier quoted context omitted.

What was the lifetime max on this plan? It probably would have left people out in the cold when they most needed it. I don't think it's wrong to expect insurance to cover people when they most need it, which was largely not true with million dollar lifetime caps. Even with the ACA, employers have the best of both worlds. Expensive older people are covered by the government, and anyone who gets to expensive can be shu…

> What was the lifetime max on this plan? It probably would have left people out in the cold when they most needed it. I don't think it's wrong to expect insurance to cover people when they most need it, which was largely not true with million dollar lifetime caps. Note that lifetime caps are a lot more generous than what they have in say the UK, where you don’t get treatment if it costs more than $50-75k per year of…

> Note that lifetime caps are a lot more generous than what they have in say the UK, where you don’t get treatment if it costs more than $50-75k per year of extended life

Do you have any data for that? Sounds odd.

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

#178

Post by magashna »

irq11 wrote: post #162
mieseratte wrote: post #155

Earlier quoted context omitted.

> If you're saying the ACA harmed the health care system, strong disagree. The system? No. Corporate welfare is great for "the system." But the consumers? Absolutely harmed! > Again: the cost increases you're talking about were a fact of life before the ACA. I've been working for over a decade now. 100% increases, year-over-year have never been even close to a thing with employer plans I've held. Not even close. Typi…

Again, consumers have absolutely been harmed by the skyrocketing cost of health care. But every bit of evidence shows that the ACA slowed that growth. The only connection you’re making here is that your own costs went up after the ACA. It’s a post hoc fallacy.

The ACA is a bandaid on a wart

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

#179

Post by Gibbon1 »

refurb wrote: post #125
tptacek wrote: post #113

Earlier quoted context omitted.

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 i…

My companies insurance premiums were going up 10-15% a year for years before the ACA.

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

#180

Post by dsfyu404ed »

lotsofpulp wrote: post #104
dsfyu404ed wrote: post #23

Earlier quoted context omitted.

If you spend a lot on healthcare (i.e. have a family) then a HSA works fine since you hit your maximums really quick and then only pay some small % of the sticker price after that. For everyone who isn't gonna spend a few grand in healthcare every year it totally sucks and is a massive incentive not to have routine care done.

That doesn’t make sense. If you spend a lot on healthcare, then why would you want to spend it out of pocket from HSA instead of letting insurer pick it up with a non HDHP?

You only spend out of pocket until the various out of pocket limits kick in.
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