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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

#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 oncology hospital within 500 miles, and I was able to get scans, tests, etc on a very short turnarounds. Ultimately I had two major surgeries in 4 months, and the whole thing probably cost the insurance company a couple hundred thousand dollars. Since my parents had already hit their out-of-pocket maximum, the marginal cost to us was 0.

Now, the "when it worked" caveat is a big one. The story would be very different if my parents didn't have insurance at all or if I hadn't been eligible to be on it. But the same story today on my insurance would cost me a lot more money out of pocket due to a much higher deductible and a higher out-of-pocket maximum.

My perspective is that the ACA made things significantly better for a small group and modestly worse for most people. I'm open to moral arguments that the tradeoff was worth it (although that's not what I believe.) But I dislike rhetoric that pretends there's no tradeoff at all.

Edit: Added substance to a one-liner.

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

#3
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…

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.

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

#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?

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

#5
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?

Generally, but I think that's a bit of a "hey people without a lot of money who can't afford more... you should save money" there.

Not that they shouldn't do it, but a slight paradox there.

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

#6
post #5
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?

Generally, but I think that's a bit of a "hey people without a lot of money who can't afford more... you should save money" there. Not that they shouldn't do it, but a slight paradox there.

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.

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

#7
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 yes that is an effective strategy, especially given the economic incentives to having a HSA and how it is possible the manage the money in the account. However, the economically “supposed to” decision for the monetary difference is now up to the insured who may not understand nor desire to put some of that difference towards the same health causes rather than change spending habits. Awareness is important here.

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

#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 getting basic preventive care is actually more expensive for them in the long run - https://www.insurancejournal.com/news/national/2018/06/26/49....

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

#9
post #5

Earlier quoted context omitted.

Generally, but I think that's a bit of a "hey people without a lot of money who can't afford more... you should save money" there. Not that they shouldn't do it, but a slight paradox there.

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.

HSA is spend it or lose it.

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

#10
post #5

Earlier quoted context omitted.

Generally, but I think that's a bit of a "hey people without a lot of money who can't afford more... you should save money" there. Not that they shouldn't do it, but a slight paradox there.

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.
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