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The elephant in the room is health insurance. We have a system where even if you have a fairly good income, buying insurance as an individual (or as a small com
by saghm 7mo ago
The elephant in the room is health insurance. We have a system where even if you have a fairly good income, buying insurance as an individual (or as a small company that isn't buying in a volume high enough for insurance companies to want to give you a discount) means that you'll in all likelihood be paying a lot more for a lot less coverage. The ACA attempted to solve this by having insurance companies offer plans on "public exchanges" by state and then subsidizing the costs, but because most people making good money get insurance through a job with benefits rather than buying it directly, in practice there aren't really any options on the public exchanges calibrated for people with high incomes. (Plus, if you live in a red state, they've likely refused to take the subsidies, which means either the prices are higher or the plans are even more meager based on what the insurance companies expect people without benefits through employment to be able to afford, or both).
- IG_Semmelweiss 7mo agoThat's no longer true. You can have ICRA etc plans, for the tax benefits. The truth of the matter is that employers pay a humongous share of the health insurance bill, and if you shop directly, you will pay that 100% on your own. You do have to put in a little more effort, but as an employer you can build a hybrid plan and contract with certain networks, and lower your bill tremendously.
- hansvm 7mo agoThey're still maybe right. In CA, it's pretty common for the best plan you can buy as an individual to be half as good as whatever your employer offers and to cost twice as much as the combined employee+employer contribution. How does ICHRA fix that? What's this "contracting with certain networks" you're referring to?
- valleyer 7mo ago> Plus, if you live in a red state, they've likely refused to take the subsidies No. Individual states can refuse Medicaid expansion, but that does not have any bearing on the health insurance marketplace / premium tax credit ("subsidies"), which states cannot opt out of.