What were they saying about “affordable” health care⁉️ You see, while the politicians and pundits focus on subsidized premiums and call that making health care affordable, the real world is still out there. Let’s try one more time; affordable health care is NOT simply subsidized premiums. 😷
A new analysis points to the difficulty families have paying for the ever-growing cost of health care, especially given increasing deductibles.
The Kaiser Family foundation analysis released Wednesday finds that most families don’t have enough assets to cover a mid- to higher-range deductible in a private health insurance plan.
Specifically, Kaiser said, less than two-thirds (63 percent) of non-elderly households with incomes above the federal poverty level have sufficient liquid financial assets to cover a mid-range annual deductible of $1,200 for an individual or $2,400 for a family.
By comparison, the average general annual deductible for single coverage among workers enrolled in an employer-based health plan was $1,217 in 2014.
About half (51 percent) of households have enough liquid assets to cover a higher-range annual deductible of $2,500 for an individual or $5,000 for a family. In 2015 plans offered through Healthcare.gov, the average combined medical and drug deductible for single coverage in a silver plan was $2,556.
Among low- and moderate-income households, even fewer are able to meet deductibles.
For example, just a third of lower-income families have sufficient liquid financial assets to cover a $1,200 deductible for an individual or a $2,400 deductible for a family, and 20 percent have enough to cover an annual deductible of $2,500 for an individual or $5,000 for a family.
QUINNSCOMMENTARY 
I thought about posting on BenefitsPro, but, decided against it. Here is my post on Linked In.
Certainly correct that any deductible will be too much where there is no financial preparation.
However, the alternative, 1st dollar health coverage, is probably not a workable solution for most Americans, either. It requries much greater up front financial support that does not build any cushion for the time when medical expenses are incurred – meaning it must be maintained indefinitely – cradle to grave, womb to tomb.
So, the concept of HSA/CDHP is more akin to funding a lifetime of day-to-day medical expense (short of catastrophic expense) over a lifetime, while funding catastrophic expense with insurance. So, Health Savings Accounts only work where they are actually used, where people fund the accounts in anticipation of day-to-day and periodic medical expenses. And, where deployed properly, HSA/CDHP programs have been shown to be successful for most workers.
The exception, where an effective HDHP/HSA combination will not be sufficient coverage, is for those with significant chronic medical conditions and those with truly catastrophic medical expenses – hundreds of thousands of dollars and millions of dollars. The HDHP/HSA combination will still “work” in these situations if the deductible is set below the maximum annual funding to the HSA. But not really, that’s not really sustainable. Sooner or later, for almost all employers (other than perhaps truly jumbo plans), the cost of the underlying insurance, the HDHP, even with a stop loss or reinsurance provision, will ultimately increase beyond affordability. But that is not a weakness of the HSA/HDHP – it is a weakness of the employer-sponsored system we have.
So, as indicated in the comments to the initial post which lamented PPACA shortcomings, we need a societal backstop to employer-sponsored plans (somewhat akin to the backstop the Transitional Reinsurance Program represents for the public exchanges). At some point, significant medical expense becomes a societal issue (if only because at some point costs increase so significantly that the employer must drop the plan as unaffordable – or no longer the most cost-effective solution to provide coverage).
That is where federal health reform should have focused – where and when does expense become a societal issue, beyond the reasonable capability of most employers, where a social insurance program is a necessity. In other words, at some significant level of attachment point, that is where we should have targeted taxpayer assistance to fund a (not so transitional) reinsurance program – not just for public exchange options, but also for employer-sponsored plans.
It is not too late to adjust PPACA into something workable and sustainable – regardless of the decision in King v. Burrell. Unfortunately, those with the authority to make changes and their staff members, probably don’t have much experience, or the appropriate experience in employer-sponsored health plans and reinsurance. They have mostly been schooled in the Federal Employee Health Benefit Plan – a great option if you can depend on somewhat unlimited taxpayer funding.
And, of course, much like prior to PPACA, there would be no consensus on a solution. Back in 2008, there were maybe five or six specific designs under consideration -but no consensus. There was consensus on the fall back position. If “my” design was not selected, everyone agreed on the most viable option – to maintain the status quo. Unfortunately, returning to the status quo ante of PPACA is no longer a viable option because of all of the disruption to state insurance and employer coverage marketplaces.
So, sooner or later, people will search for a solution to PPACA’s shortcomings, and the cycle will repeat. Maybe that will occur in time to retain the employer-sponsored system most Americans have, and maybe, as predicted by Professor Emanuel and Professor Gruber, it won’t.
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