Replace the ACA with What??

Take Two Aspirin

It’s pearl clutching time for the opponents of the Affordable Care Act and Patient’s Bill of Rights.  The premiums are going up.  Yes, and what did a rational person think was going to happen in a system based on private health insurance corporations selling policies?  Further, before swallowing all the hyperbole there needs to be a bit fact checking.

First: This is far from a Nationwide Crisis – calm down – as Think Progress advises

“Although some news outlets are characterizing the news about rising premiums as a “November surprise” that could have a big impact on how Americans feel about the upcoming election, the reality is that these price hikes won’t affect the majority of the country. Most Americans get their insurance either through their employer or through a safety net program like Medicaid. A much smaller portion of the population — about 6 percent — buys private insurance plans on Obamacare’s marketplaces.”

Second:  If the premiums go up so do the subsidies. Again, Think Progress explains —

“Critically, Americans won’t need to shoulder Obamacare’s premium increases on their own. Most people who are insured through Obamacare’s state-level marketplaces don’t pay for the full price of their premiums because they get an assist from the government in the form of subsidies. These federal subsidies to help offset the cost of buying insurance are also going to rise. According to the Obama administration, even with the projected increases, more than 70 percent of people buying insurance on the marketplaces will be able to get a plan for less than $75 a month next year — provided they take advantage of the subsidies available to them and select a low-cost plan with more limited benefits than other options.”

If a person is covered under the terms of an employer’s health insurance plan, Medicare, or private insurance purchased on his or her own – this is not an unexpected increase, nor is the increase in premium costs essentially any more than what other policy premiums will see.  There is no need to grab the pearls, hit the fainting couch, or even to have to take two aspirin.

The Replacement is Worse Than The Current System

If one is inclined to take on headaches, none may be more miserable than what the Republicans have in mind for replacing the Affordable Care Act. If clutching pearls and twisting open the adult-proof cap on the painkillers is desired then by all means – support the Health Savings Account idea.

There is nothing new about this idea, and nothing particularly good about it.

‘A creation of the 2003 Medicare act, HSAs do offer employers the hope of curbing their insurance expense. Under the law, the accounts, which enable workers to set aside pre-tax dollars they can later use toward their out-of-pocket medical expenses, must be offered in tandem with a high-deductible health plan (HDHP).” [cfo]

As originally envisioned the HSA is combined with a high-deductible policy.  Thus for any employee there’s a double whammy.  More money out of the paycheck for the HSA and more money out of pocket for the health insurance plan.  But, doesn’t this make the consumer more cost conscious? Yes, and that isn’t necessarily a good thing.

“Studies have recently confirmed the worst fears about such plans: They can induce beneficiaries to stint on health care that they truly need. According to the Employee Benefit Research Institute study, 35 percent of the people in CDHPs and 31 percent in HDHPs “reported delaying or avoiding care, as opposed to 17 percent of those in comprehensive plans.” [cfo]

Avoiding treatment is NOT a desired outcome of any wellness plan.  If you need more convincing that HSA’s are not the answer, look to Five Reasons Not To Enroll In An HSA —  no drug copays; no immediate financing; high deductibles, 213(d) confusion over what’s covered; and an “education gap” about these products.

Seeking more information about this rather bad idea compliments of the Republican Party and their allies in the corporate insurance and financial markets?  There’s The Truth About HSA’s; Here’s Exactly How Terrible Paul Ryan’s Obamacare Replacement Plan Is; HSAs mostly benefit high income taxpayersGAO study confirms HSAs primarily benefit high income individuals; Making Health Care Worse.

The Health Savings Account is another idea for a nice tax shelter, for young healthy, wealthy people.  It is not an answer for addressing general health care cost containment, especially not if people tend to put off medical treatment until their situation is serious or dire.  In less polite terms, it’s the 0.01% answer to a problem affecting the other 99.99%

Previously in Desert Beacon: All Right Everyone, Gird Your Loins! The GOP’s Coming For Health Insurance Reform Repeal (four years ago)

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