Response to The high-deductible plans in the Affordable Care Act

I posted this as a comment to Ezra Klein’s post, The high-deductible plans in the Affordable Care Act. My complaint with his post is that although high-deductible plans are in the Affordable Care Act, they made them very expensive when compared to existing high-deductible plans. If this is reform, I want no part of it. The changes to high-deductible plans are bad public policy if we expect individual responsibility and market forces to reduce future health cost increases.


As a person with "skin in the game" I did a price check on high deductible plans in Ohio and Massachusetts and found that high deductible plans appear to be an Affordable Care Act victim. I chose Massachusetts since it is our best example of Affordable Care Act in action. The price for the lowest price high deductible plan in Ohio would cost me $305 per month and the lowest cost Bronze plan in Massachusetts would cost me $1,296 per month. That is a 425% cost increase. As a healthy family we would be paying an additional $11,892 per year. My family’s 35 years of health care expenses excluding insurance premiums is just slightly larger than one year’s insurance premium in Massachusetts and a large percentage of that amount was paid out of my annual deductible. People like me should be a health insurance company’s dream customer but evidently not in Massachusetts. So despite the fact that Massachusetts is offering a low cost, high deductible plan it is a really bad deal when compared to Ohio. If Massachusetts cannot provide health insurance at competitive rates to Ohio, it is highly unlikely that the Affordable Care Act will provide competitive rates either. As a country we spend twice what the rest of the developed countries spend on health care and we get the same health outcomes. Massachusetts spends over twice what the rest of the developed countries spend on health care. There is something fundamentally wrong about the way spend money on health care and it appears to be institutionalized in Massachusetts and in the Affordable Care Act. Affordable health care are words that were lost in translation when they wrote the Affordable Care Act.