And a lot of insurance companies are selling "lower premium/high deductible" insurance linked to wellness plans and HSAs to companies, especially pushing the premise that a healthy workforce is cheaper in the long run. There's also a lot of confusion about what constitutes a "cadillac plan", otherwise known as an executive benefit health plan (cosmetic plans because looking good is part of the job, unlimited network coverage, minimal or no premiums, co-pays, or deductibles), which is due to be "taxed" to help cover basic coverage.
(added on edit - )
So a lot of otherwise employer-based good plans that woudn't have seen an increase in cost to the employers are being phased out for these new plans due to the confusion.
And of course, with these new plans, there's a significant advantage for a healthy, young employee, who can just bank whatever is left over in the HSA paying for the deductible into a Roth that will cover any serious problems that come up later on in life, dontchknow...
Pretty much all of these plans puts more of the cost to the employee and much less to the employer - by perhaps a couple tens of dollars, or by increasing costs with loss of certain types of medical coverage they had previously.
Unfortunately, these plans have f'ed up prescription pricing in most non-government plans, which also kicks the price up to the employee. Especially since in most prescription plans, you have to meet the deductible before the costs go down instead of depending on the old tiered coverage system, which really screws up the beginning of the year if you've got someone with a chronic disability. My husband has an injection he has to take every two weeks; under the old plan, it was $30 a shot; under our new plan (which took affect Jan 1 of this year!), we had to pay $925 a shot out of pocket until we reached our $3K medical (not medical, optical, and dental) deductible, and then it drops down to $25 a shot.
And to pay for it... oye. Unlike an FSA (an actual ACA F'-up that needs to be addressed - if you have an HSA and an FSA, the FSA is only good for dental and optical!), the HSA starts out at $0 at the beginning of the year, unless your company will kick in some money out of the goodness of their hearts; you add to it via payroll deduction, and it goes up soooo slooowly; especially for those high-cost prescriptions. And the limits for HSAs and FSAs - I guess families aren't supposed to expect more than $8000 "tax free" for medical every year. So, we could only get a $2500 max FSA because we also have a $5500 (@ $200+ a bi-weekly paycheck) max HSA.
The old FSAs were so much better; fully funded from the beginning of the year, so you could meet your deductible without affecting the ability to keep a roof over your head even after they switched your prescription plan to a gawd-awful "negotiated cost until you reach your deductible" plan.
Implementing ACA in itself does not raise costs. But the rules of the ACA gave the insurance companies too much lee-way in setting the price-point and some of the policies they could follow, so they did what they could to ensure they could still make as much profit as they can.
I can't wait until I'm eligible for TriCare for Life - six more years!
Haele
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