3 thoughts on “In the Old Days, the Left Disliked Deductibles”
I’ve noticed that too. I always thought that was the original reason California never recognized HSAs, back when high deductibles were bad. But at the rate people are now fleeing the state before withdrawing from their retirement accounts, it’s surprising they still allow IRA and 401-k deductions.
I nearly always appreciate Dr. Goodman’s comments, but I think he is taking a cheap shot here.
The bronze plans with high deductibles were not put into the ACA by leftists. The real leftists
(like Bernie Sanders, Jan Schakowsky, Henry Waxman, et al., wanted Medicare for All with zero deductibles.)
The bronze plans were included in the ACA in order to offer plans with very low premiums. There is a bloc of people who will not purchase health care if it costs $20, even if they have $20.
The misleading headline in this article assumes that “Since leftists like the ACA, because it is a way station to single payer, then leftists supported and helped create every feature of the ACA.”
High deductibles like those in the ACA’s Bronze plans interact with the rebate policies of our convoluted drug pricing system. Over the past decade, both the Average Wholesale Price (AWP) of drugs and the rebates drug manufacturers pay PBMs and/or health plans have increased significantly. Since patients’ out of pocket costs are typically based on AWPs, they don’t benefit from these rebates and therefore overpay for drugs out of their deductibles. The higher the deductible, the greater the overpayment. Through this mechanism, low income workers on Bronze plans are subsidizing drug costs for higher-paid employees on regular commercial insurance.
I’ve noticed that too. I always thought that was the original reason California never recognized HSAs, back when high deductibles were bad. But at the rate people are now fleeing the state before withdrawing from their retirement accounts, it’s surprising they still allow IRA and 401-k deductions.
I nearly always appreciate Dr. Goodman’s comments, but I think he is taking a cheap shot here.
The bronze plans with high deductibles were not put into the ACA by leftists. The real leftists
(like Bernie Sanders, Jan Schakowsky, Henry Waxman, et al., wanted Medicare for All with zero deductibles.)
The bronze plans were included in the ACA in order to offer plans with very low premiums. There is a bloc of people who will not purchase health care if it costs $20, even if they have $20.
The misleading headline in this article assumes that “Since leftists like the ACA, because it is a way station to single payer, then leftists supported and helped create every feature of the ACA.”
T’aint so.
High deductibles like those in the ACA’s Bronze plans interact with the rebate policies of our convoluted drug pricing system. Over the past decade, both the Average Wholesale Price (AWP) of drugs and the rebates drug manufacturers pay PBMs and/or health plans have increased significantly. Since patients’ out of pocket costs are typically based on AWPs, they don’t benefit from these rebates and therefore overpay for drugs out of their deductibles. The higher the deductible, the greater the overpayment. Through this mechanism, low income workers on Bronze plans are subsidizing drug costs for higher-paid employees on regular commercial insurance.