The true-false questions presented here are fully explained in the memo A 2024 Health Care Reform Proposal.
- High-deductible health plans coupled with health savings accounts are more likely to prevent a $25,000 to $50,000 out-of-pocket health expense than short-term health insurance.
- The sum of deductibles and worker share of premiums has decreased since the passage of the ACA.
- Tax preferences associated with health savings accounts are smaller for low-income people than for high-income people.
- The Senate could make major changes to the tax-treatment of employer-based insurance and the premium tax credit based on a majority vote.
- Short-Term health plans provide great protection if total health expenditures remain below the annual cap.
- The ACA guarantees that people purchasing state-exchange health insurance have access to top cancer hospital if they get cancer.
Answers and Discussion:
- True. High-Deductible health plans cap out-of-pocket health expenditures. The current out-of-pocket limits are $7,050 for an individual policy and $14,100 for a family policy. The arbitrary benefit exclusions on short-term health plans can lead to large out-of-pocket expenses for relatively minor health problems.
- False. The sum of deductibles and worker shares of premiums has risen since passage of the ACA.
- True. HSA contributions are deductible. The value of the deduction is determined by marginal tax rates. This disparity could be eliminated by replacing the HSA tax deduction with a tax credit.
- True. if done through the tax reconciliation process. Several tax changes are proposed in the book including the tax credit discussed above and the replacement of the tax subsidy for employer-based health insurance with an employer subsidy of state-exchange insurance.
- False: A three-day stay in the hospital could result in thousands of dollars of health expenses for people covered by a short-term health plan. The book points the reader to some papers that found problems associated with short-term health plans could be rectified through reinsurance subsidies or by allowing automatic access to Medicaid for people covered by a policy with an annual cap.
- False. In fact, state-exchange health insurance policies tend to have narrower provider networks than employer-based health insurance policies. The book discusses how issues related to narrow network policy might be addressed through network adequacy regulation, expansion of the No-Surprises Act and new subsidies.
I am not looking forward to a 2024 debate between advocates of Medicare for all and people who want to tinker around the edges of the ACA. The memo A 2024 Health Care Reform Proposal makes the case for a centrist-flavored overhaul of health insurance in the United States.