ACA news – Marketplace “Enhanced Silver” beats Marketplace Bronze, even if the premium on Bronze is cheaper.

This one from the New York Times, about the generally high deductibles that buyers in the Health Insurance Marketplace face when they don’t know to get the Silver Plan (AV70) as opposed to a Bronze Plan (AV60).

What the news media have not been pointing out about the high deductibles on the ACA Marketplace are the following:

1) Unlike the coverage that has been offered in America up to December 2013, the new coverage is fairly permanent, as long as you keep paying the bill. Even with employer-based group plans, you LOSE your coverage the day you LOSE your job. You’re then stuck in Cobra, paying the full price plus 2% administrative.

2) For the vast majority of Americans (9 in 10) buying in the ACA Marketplace, the out-of-pocket (OOP) is capped on a Silver Plan. The cap is about $4500 max in 2014. Even this $4500 can be offset through the use of what’s called a Health Savings Account, which has a tax-deductible component.

3) For another large segment of Americans (250% federal poverty level MAGI and below), the Marketplace automatically “enhances” your Silver Plan. This means that a cost-sharing will happen between the federal government and you, if you happen to use your plan in a given year. Your OOP can be as low as $700 in that case.

4) One criticism of the Affordable Care Act is that it “didn’t rely on market based alternatives” or alternatively that it “was big government takeover of health insurance”. If you were healthy, you were being “forced” to “buy something you’d didn’t want”, whether you needed it or not.

However, NOW the complaint is that the cheapest plans on the Marketplace require self-insurance (i.e. they are high deductible). Self-insurance is the so-called free market at its best: you negotiate your price, and can withhold from expensive doctors and use less expensive ones. Only now the opposition is saying, that this is like “no insurance at all”. So which is it? Free market good or uninsured condition bad? It just sounds like people like to revel in ignorance, and say whatever they have to as long as it’s negative. I’d like to see more information put out about Enhanced Silver, and the insurance companies can easily do this.