The thing is (the failure to recognize which actually delayed us, for reasons of caution, switching to a high deductible plan for a couple of years) is that once you've had a couple of "healthy years" (low healthcare costs) you will have accumulated enough of a balance in your HSA to ensure you can handle a bill of a few $000's without it causing a financial problem.

Those would be the catastrophic health events that I referred to above.
But that's the point, that if people have to cough up $6,500 they will put up with their joint pain just a little longer rather than rushing off for expensive surgery paid for by their insurance, ..... surgery which doesn't even guarantee a complete solution anyway. In the mean time, some will discover the pain goes away or is seasonal, others will discover that occasional pain relief drugs or alternative therapy gives them sufficient relief. Some of that expensive surgery will be postponed for years, some of it will never be needed after all.

You would need to look at all the numbers .

Seemingly the subsidy does not exceed the Bronze premium, if it did then that would make a difference.

From a provider point of view, I do not like using Insurer as it is not really Insurance, the majority of your business is going to be those buying the basic to comply or who can only afford whatever is cheapest.

Costs time and money to price and administer plans that are not big sellers, so why bother

Logically buyers of lower deductible plans do so because they expect to get there money back and some. Whatever age group.

As effectively only the Bronze plan has a cross subsidy you would expect the others to either and die away.

The only way I could think it would work for an individual is if you had an event that allowed you to change plans mid year. Say it was October and you moved States and had a lot of expense coming in at the end of the year.

I understand what you're saying, and I do think in UK or US there is much unnecessary medicating/procedure simply because people want all things 'fixing'- fast- but that is also way expensive here because medical businesses expect to make huge profits, and they are huge power-machines to generate the advertising and 'received wisdom' to influence people's medical decisions.

No but any plan can't have more than $6,250 maximum out of pocket expense per individual. Therefore if you have cancer, a stroke, heart attack, or hip replacement surgery you'll probably reach the maximum out of pocket expense no matter which plan you have and in that case, the platinum plan will probably cost you more in insurance premiums plus copays than the bronze plan. A bronze plan will likely have a maximum out of pocket expense of $6,250 and a platinum plan may have a $4,000 maximum out of pocket expense which is a difference of $2,250 which is less than $200 per month. So in most cases, if you don't get seriously ill, you are wasting money buying an expensive platinum plan and if you get seriously ill, it doesn't matter which plan you have.

@ Michael yes. If you have a serious illness the platinum policy is the way to go ( as in my case ) it's something like $1500 cheaper buying platinum than bronze for me based on my projected expenses for 2015. And that's only because I have choice of 4 platinum policies this year- 3 are way more expensive and last year I don't think there was even one on offer.

But check the plan formulary too anyone who needs expensive medications- some are not covered in the bronze policies. That's why the websites need to be fixed is what I keep going on about!

If both medial insurance and drug benefits are covered by a plan the maximum out of pocket expense for medical plus drugs for any plan is $6,250. If you need cancer treatment including over $100,000 worth of drugs, the maximum out of pocket expense will not exceed $6,250 per individual per year.

So the foundry in that case makes no difference.

Not all drugs or treatments are covered by all policies.

Here's an article about it Under Obamacare's "Closed Formularies" Patients With Serious Chronic Diseases like MS Don't Get Access to Vital Medicines - Forbes

My point is if the websites aren't working and you need a specific prescription and cannot check if it is on a policy list of covered drugs, that's a problem to fix!

In 2014, ACA was not fully implemented and companies could take advantage of that delay and some did. In 2014, an insurance company could decide to not include the deductible and/or copays as counting towards the maximum out of pocket expense and 38% of the policies written had some way of getting around the maximum out of pocket expense. Out of network services is not included maximum out of pocket expense but that can be expected.

The full protections of ACA begins on January 1, 2015.

I haven't read fully the 2015 ACA regulations but suspect that the January regulations also doesn't allow for insurance companies with foundry included to not cover drugs just because they aren't in the foundry. Insurance companies still have a team of lawyers trying to figure out loopholes to get around ACA rules to give the insurance company one up on profitability as compared to other insurance companies. That is known as effective management and they give themselves large bonuses if that can be accomplished.

Republicans claimed that ACA was ridiculous since it was over 2,000 pages long but if it was only about 50 pages like Medicare reform, insurance companies did whatever they wanted since loopholes can always be found in a poorly defined bill that doesn't spell out exactly what the insurance companies can do.

There are that there are still a lot of issues to be resolved with the web site but ACA is 100 times better than pre-ACA. If you have as many health problems as you claim and ACA was not implement, I suspect you'd have no choice but to go back to the UK since you wouldn't be able to afford medical coverage. If health insurance was still like pre-ACA. you'd definitely be offered only a risk pool policy at probably $1,400 or more per month with a $20,000 deductible, a 30% copay, unlimited out of pocket expense, and no prescription drug benefit.

14 years ago, the only policy I was offered was a risk pool policy costing $600 per month, $10,000 deductible, 30% copay, unlimited out of pocket expense, and no prescription drug benefits and that was because my medical records indicated that I had a 'fatigue" problem.

You are so right. My OH is about to start his second year of insurance through the scheme, and he has saved a load of money with no diminution in coverage. Was it easy to get set up? No -- both times! He had to stick with it and persevere with a balky website and phone call after phone call to employees who were learning on the job; but in the long run it has definitely been worth it and one has to believe that the system will continue to develop and be refined. I cannot believe that the now much-loved NHS came into the world perfectly tuned!

'If you have as many health problems as you claim'

@ Michael...don't you think that's rather offensive language?

Are you implying I am lying, deluded, what???

Made me feel glad I hadn't disclosed too many details of my disability anyway, one of which is extreme fatigue btw. I'm still coming to terms with it so I don't quite know how to deal with rude /insensitive comments or the ever-present insistence: sign up to disability benefits, as though it's some kind of social prize.

I have to jump through hoops at every turn it would seem- with the healthcare provisions, with the doctors/hospitals, and even with other humans- many who claim to be sick themselves!

I wasn't implying anything and was not meaning to question that you have serious health issues. I could have said "with all the health problems that you have" but then I would be making an assumption that I know what health problems you have.

How would you have phrased it without knowing the specifics?

I'm really not into the pc-policing of language, so I'll just say I am quite touchy about the whole subject of health and healthcare...

Do I think ACA is better than nothing? Well that remains to be seen as I continue to plough my way through the mire of mistakes and bureaucracy.

It's not what I voted for Obama for that's for sure.

But it's probably best to stick to practicalities rather than politics- applying for 'obamacare' is time-consuming, confusing, and stressful. I think I did better this year knowing and accepting that.

And my advice to people- do it now. Don't hit the 'do it later' buttons on anything if you can help it, as it may take you days to get back in, and if you do and the system has malfunctioned you may have to start over...
Also- save any available info. The insurance co websites info was mostly in pdf links. Save them to compare at leisure because my experience was that soon after everyone started applying they were unavailable for days. And the government website 'apples to apples' comparison says 'no available data' more often than not.

From what I've seen and heard from others' experiences around the country, the ease of getting signed on to the ACA varies tremendously from state to state.

This was my first year signing on, and I made a few basic mistakes that I won't make next year, which I hope will make the process easier for me. Any new system will have glitches, and even with no glitches a new system requires a learning curve on the part of users.

I'm happy to have reasonably-priced health insurance, even though when I started this thread I despaired of that ever, ever happening. I was convinced that the husband and I would not be able to use the ACA system... until I heard from enough others who had had similar or worse troubles with my state's website. Then I began to have some hope.

I have to echo Nutmegger's suggestion to just keep trying the Helpline. That's what worked best in the end for me. As someone said above, the Helpline staff are learning as they go, too, so you may have to call and speak to several "helpers"; some are definitely better than others, and will share tips & website guidance--one gent in particular was determined to help me solve my final problem.