tom169

We've had enough saved maxing out 2 HSAs and a small amount from savings to cover max OOP for each year I've been here. If either or both of us get hit by a bus then I like to know we won't be going into debt to figure the situation out.

Giantaxe

I think you missed the irony of what you responded to... many don't have the "luxury" of "... sensibly only needing medical attention after a three-year planning period...".

As I've said many times, high deductible plans are great if you are healthy enough to be able to build up a wad of cash in your HSA. But they are arguably poor public policy in that they "siphon" off healthier participants into a high-deductible pool, leaving the less healthy in more traditional insurance. Additionally, by using the tax system, they benefit most those in higher marginal tax brackets.

Having said all that, I have a high deductible plan myself and it's worked well for me.

tom169

Oh I got it. Not sure you got the point where I could have paid for it any year of being here. At the start would have taken some of my regular savings. Now it's profit from investments.

The government needs to coerce people into thinking about their health expenses. A good way to do that is a tax sheltered vehicle.

Giantaxe

We know you could have. The point is that many aren't in that position because of ongoing health issues, so they never get to build up the value of an HSA.

Government coercion through the tax system can happen other than through the benefit being pegged to one's marginal tax rate. If the goal is to maximize access to healthcare, you don't give the largest benefit to those with an income that likely means they can most afford it anyway.

scrubbedexpat099

Agree, why do it through the tax system if you want a Gov Subsidy why link it to tax?

tom169

Because you still have to save more than the government effectively subsidizes.

carcajou

No. No! This can't be true because Obamacare is low-cost health care for poor people. Haven't you read all the insistent posts about that over the years from all the Usual Suspects?

retzie

I think about mine plenty. Except my (large, multi-national) employer doesn't offer an HSA. There's just not a whole lot to do when the option isn't on the table.

Exactly. But even those of us who ARE healthy enough and wealthy enough to be in a position to plan, don't always have employers who offer this option. (Which of course doesn't stop my non-HSA plan from having a plenty high deductible. Something something lose-lose )

durham_lad

That is just how it is done in the USA and why the tax code is so huge and complex. Many thousands of tax preparers would be out of work if the myriad of government subsidies available were done outside the tax code.

tom169

Somewhat surprising that a large company hasn't yet started to offer HDHP. After all it's benefits that help sell a company to new talent.

Giantaxe

ACA subsidies don't work that way. But it's certainly true that that is the way many of both parties roll. Those "middle class" votes must be "bought" somehow.

Giantaxe

I doubt companies offer an HDHP to acquire talent. They offer them to save themselves money.

durham_lad

tom169

Giantaxe

Techniques I am about to embark on to get an ACA subsidy for my wife's healthcare until she reaches Medicare age... so, yes, I certainly agree that there are flaws to the ACA approach as well. Other possibilities are doing what Britain used to do with mortgage interest and limiting "relief" to the lowest rate of tax, or simply having a credit -possibly refundable - against tax. Either way avoids a situation whereby higher rate tax payers benefit most.