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For thrifty consumers, there’s a lot to like in high-deductible health insurance. The plans offer low monthly premiums and those fees fully cover preventive care, including annual physicals, vaccinations, mammograms and colonoscopies, with no co-payments.

The downside is that plan participants must pay the insurers’ negotiated rate for sick visits, medicines, surgeries and other treatments up to a minimum deductible of $1,500 for individuals and $3,000 for families. Sometimes deductibles are much higher.

Let’s keep it civil.

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[-] tburkhol@beehaw.org 12 points 1 year ago

I think the HSA is a big attraction for the GOP - tax advantaged encouragement to get more people investing more money in stocks. Practically, though it also means more people effectively self-insuring. My deductible is $6500, but I'm allowed to put $3500 into HSA, so 2 years' HSA savings covers the deductible. Fine, for individuals that are reasonably healthy, but it reduces the pool of money that insurers have to pay benefits to people who do have claims.

Essentially incentivizing individuals to sabotage the system.

[-] jasondj@ttrpg.network 1 points 1 year ago
[-] tburkhol@beehaw.org 1 points 1 year ago

Individual, ACA. $7000 annual premium, $6500 deductible, $6700 max out-of-pocket, so it really only covers catastrophic care. 2023 HSA limit is $3850, up from 3650 in 2022 because of inflation. Please excuse me for rounding - that $350 makes all the difference.

[-] jasondj@ttrpg.network 1 points 1 year ago* (last edited 1 year ago)

Yeah, that’s rough buddy.

I didn’t realize Max OOP limits were so high. I’d say it’s bullshit that HSA contribution limit isn’t tied to the max annual OOP.

My family OOP is lower than family contribution limit. Hadn’t realized that it could be any other way.

[-] tburkhol@beehaw.org 1 points 1 year ago

It's not a hardship, though. I'm healthy with no chronic conditions, and I've made the specific choice to go with a HDHP to get the HSA, which I treat like a pre-tax Roth IRA. If some catastrophe happens, it'll be easier to pay for surgery out of the HSA than a real Roth, but I don't expect to see doctors until Medicare. I don't even pay for glasses out of the HSA, because its future value is too great.

This is a perfectly rational individual choice to maximize my personal benefit, but it is terrible policy at the population level. It means there are less resources available for the small minority of people who do have expensive health issues, because I'm diverting my insurance premiums into a retirement fund. This is a recurring theme in right wing policy - it's fine for people whose lives have no major complications, and people with special circumstances are too few to consider. You have to look out for yourself, and a few people will fall through the cracks, which is a borderline sociopathic attitude.

this post was submitted on 22 Aug 2023
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