Yesterday I made a comment on the post, Do Obamacare’s three “mores” spell long-term failure?, highlighting my concerns that the Affordable Care Act makes it very difficult if not impossible to bend the health care cost curve. I used as an example my own situation and pointed out that if I had to purchase health insurance on the exchange today I would get a subsidy that would pay the majority of the cost increase. My costs would go up but the government would be stuck with most of increase. That is the good news. The bad news is that I have an out of pocket cost dilemma. If health care reform was working right then I should be selecting a silverish bronze plan from the exchange with a similar out of pocket cost to my current plan. The problem is that the cost for a similar plan from the exchange will be greater than my HRA allotment and the excess amount will be paid out of my disposable income. To avoid this problem I am being nudged from my 2013 silverish bronze plan to the lowest cost bronze or catastrophic plan and building up a much larger savings account for health emergencies. The Affordable Care Act has has forced me into a riskier financial profile. Since most of my health care costs for 2014 will probably fall below the deductible and the deductible has gone up to at least $6,350, it is even more important from a personal finance standpoint to have this savings account fully funded. So here is the dilemma. Do you buy catastrophic health insurance and gradually increase the savings rate or go “cold turkey” and dramatically increase your savings rate? If you are living paycheck to paycheck without any wiggle room in the family budget for increased savings then you are stuck in the Affordable Care Act donut hole. Hmm this could get ugly!