[howard941]

They may be hitting the 80/20 rule W/R/T PPACA premiums but the out of pocket for almost everything not negotiated by the executive branch is out of this world. Common generics have become crazy expensive. Don't even go to the on-patent meds: They're unaffordable for all but large employer plans and the policies covering Federal employees.

[jachriga]

They only hit the 80/20 because of the account-keeping shenanigans allowed by the PBM/manufacturer/plan negotiations. It would not surprise me if the rebate system were completely done away with and health plans had to spend the real amount compared to what they "spend" now, that premiums would go down and/or coverage would go up. I don't believe for a second that there are any such backroom negotiations involving a mostly-invisible 3rd party (the PBMs) that benefit patients in any way.