<p>The premium difference between platinum and bronze is more than the deductible and more than the maximum out of pocket. </p>
<p>If I buy the most expensive Bronze HSA plan available to me, my premium for the year is $7848. Maximum out of pocket is $6350 – so maximum possible outlay for me is $14198.</p>
<p>The premium for a Platinum plan would be $13032 – a $5184 difference, which is $684 more than the $4500 deductible on the HSA plan. I don’t start to see any sort of savings from the Platinum plan until medical costs reach $10,000 - but if costs exceed $12,000 then I would still have a 10% copay on the Platinum whereas at that point on the Bronze plan I would have exhausted my maximum out-of-pocket and the insurance would be paying 100% of the bill.</p>
<p>Maximum possible outlay on Platinum (adding the policy amount to the maximum out of pocket of $4000) would be $17,032, almost $3000 more than the Bronze maximum.</p>
<p>Another absurdity is that the $63,000 couple gets to pay 24% of their salary for the lousy bronze plan, and the subsidized couple who pay a fraction of what the unsubsidized couple pays gets to enroll in the silver plan, a slightly better lousy plan.</p>
<p>If they are making $62,350 then they don’t have to deposit $75550 to their HSA account. They can deposit $200 to the HSA account and they will have brought their income doesn to subsidy level. </p>
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<p>The “subsidy” is a TAX CREDIT. People “game the system” to reduce their tax liability and get credits all the time – its built into our tax system. </p>
<p>I don’t think it is “gaming” to take a deduction that you are clearly entitled to in any case.</p>
<p>Goldenpooch, the point is that when we get sick, we lose income. When we lose income, we can’t pay the premiums anymore. Under the old system, that meant we lost our insurance. If we were very old or extremely ill, then we would have to use up all of our assets in order to satisfy means testing to maybe get Medicaid. Under the new system, we fill out a form online saying that we lost our job and now have -0- income and they put us on Medicaid right away, at least in the expansion states.</p>
<p>Calmom, if you had read my answer, this couple is screwed if they make $63,000, $70,000 or $75,000 a year. In any of these cases they are paying the minimum of almost 20% of their income. </p>
<p>In a way you are right about one thing: if you are making $70,000 a year you should immediately see your boss and beg him to lower your salary by $8,000. Orwell could have written a book about this law.</p>
<p>“Emilybee, in California you cannot be dropped from your plan if you are sick or you go to UCLA for care.”</p>
<p>But they could raise your rates where it could become unaffordable. Or if you lost your job and your insurance you wouldn’t be able to get any insurance at all.</p>
<p>Emilybee, in the individual market they can’t raise your rates because you were sick.</p>
<p>Calmom, that’s true about assets but remember even President Obama said Medicare and Medicaid are the single biggest drivers of our deficits and debt. With Obamacare, Medicaid spending is going to explode.</p>
<p>Calmom, the article you referenced was talking about seniors and qualifying for long term care under the Medicaid program. This will not change under the new law. You will still have to spend most of your assets before getting coverage for nursing home care</p>
<p>It’s a poor program, badly designed and written by lobbyists. The insurance lobby won. </p>
<p>17 million of the originally uninsured are not covered. I believe the top estimate at the height of the debate was 30 million uninsured. </p>
<p>Given that many of those were young people who chose to remain uninsured I’m questioning what this really solved, except to get insurers access to those young customers living at home with their parents. </p>
<p>I don’t think this law is going to work now that I see what’s really in it. It works for pre existing, but that could have been taken care of with a simple regulation</p>
<p>California supposedly has 2 million uninsured. Factoring in household sizes and the time left to enroll before the end of the year, a back of the napkin estimate is that over ten thousand people have to enroll per day to meet the goal of the law. Anyone who thinks that’s going to happen is dreaming. </p>
<p>People who once had insurance at work (like the part-time Trader Joe’s employees) lost it. People’s hours are being cut to below 29 a week. Other people’s insurance rates are skyrocketing. As of Friday, no one in California had bought an insurance plan on the exchange. Fiasco.</p>
<p>“17 million of the originally uninsured are not covered.”</p>
<p>They are not covered because certain states have opted out of the medicare expansion. There was no opt out in the law as written - only after the SCOTUS ruled states could opt out. </p>
<p>How do you know young people are going to opt out? The exchanges have barely been open. There are no figures at all yet on who is signing up.</p>
<p>“Factoring in household sizes and the time left to enroll before the end of the year,”</p>
<p>Open enrollment doesn’t end until March 1st.</p>
<p>But if this was going to be a Medicaid expansion, that’s what it should be. </p>
<p>The people this was supposed to cover aren’t covered. It’s insurance reform and it was designed as Medicaid expansion. </p>
<p>As I said, the insurance lobby won. </p>
<p>Universal coverage is the only answer if the goal is to insure the uninsured. As it is, my cost has doubled, my deductible has gone up, And I’m pretty sure the biggest beneficiaries of this are the insurance companies.</p>
<p>I was looking at how many of the uninsured would be insured by the time the policies would take effect at the beginning of the year. Using a March 1st enrollment date, just in California that’s still over 5,000 new policies per day. Still not happening.</p>