If you think paying a few thousand dollars out of pocket for medical care is painful, brace yourself. A proposed rule from the Trump administration could boost that number for families to as much as $31,000.
According to a recent report by The New York Times we see a huge shift in what health insurance could look like next year. To tackle the affordability crisis, the government is pushing for new, stripped-down, but cheaper health insurance.
Due to recent price increases, Obamacare policies have priced many Americans out of the market. More than a million people have already left Obamacare this year.
Let’s talk about the specifics of this proposal and what it actually means for your wallet. Please note that this is only a proposal so far.
The math behind the $31,000 deductible
Insurance is essentially a risk game. Under these new rules promoted by Dr. Mehmet Oz, the administrator of the Centers for Medicare and Medicaid Services, you could buy a catastrophic plan with an individual deductible of $15,000 or a family deductible of $31,000.
The pitch for these plans is simple. You pay a monthly minimum premium. If you are completely healthy and never visit a doctor, you will save money every month. But if you’re in a car accident or given a serious diagnosis, you’ll have to pay up to $31,000 before your insurance will pay out a single cent.
For most Americans, that’s not just a matter of time. It’s bankruptcy. If you don’t have that kind of money in a high-yield savings account that you can deploy today, this kind of plan is a huge gamble.
Skinny plans and missing benefits
These proposals not only increase the deductible. They fundamentally change what qualifies as health insurance.
The rules would redefine essential benefits, meaning some coverage you expect could disappear.
For example, the proposal suggests that dental care for adults would no longer be considered an essential benefit. These “skinny” policies may sound great when you’re young and invincible, but anyone with a chronic condition will eventually have to pay for almost all of their care out of pocket.
You can read more about the broader shifts this is causing in “5 Things to Know About Trump’s New Healthcare Plan.”
The danger of insurance without a network
Perhaps the biggest shock in the Times report is the push for plans without established networks of hospitals and doctors.
- How it works: Instead of negotiating rates with a network of doctors, these insurance companies pay a flat, flat fee for a specific procedure.
- The patient’s burden: If your doctor charges more than that flat rate, you will have to pay the difference.
Proponents claim this gives you the ability to shop around and find the best deal, driving down overall health care prices. But if you have a costly medical emergency, you probably won’t be able to negotiate prices from your gurney.
If you can’t find a doctor who will accept the insurer’s low flat rate, you’ll be faced with huge, surprise medical bills.
What to do now
We’re seeing people leave the Affordable Care Act marketplace as enhanced subsidies expired last year, doubling premiums for many families. According to the government’s own estimates, up to 2 million people could lose their coverage by 2027.
When purchasing health insurance, don’t just look at the monthly premium. You need to do the worst-case scenario calculation.
Ask yourself whether you can actually afford the maximum deductible. If the answer is no, you cannot afford the plan. It’s that simple. You’re better off finding a way to pay a slightly higher monthly premium for a plan that won’t destroy your finances if you get sick.
Related: “The Hidden Costs of Low Premiums: Why Your Health Plan Could Be Dangerous”
Take a closer look at your state’s marketplace options. Check to see if you qualify for Medicaid or enhanced subsidies at the state level before settling for a catastrophic plan. Because insurance is supposed to protect you from financial ruin, not guarantee it.
#Trumps #Healthcare #Proposal #Family #Survive #Deductible