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by timr 4638 days ago
No, high-deductible plans are not "illegal" under the ACA. The ACA marketplaces offer high-deductible plans. If all you want to do is pay for catastrophic coverage, you can do that.

What's happening is that some existing catastrophic plans don't meet the requirements of the ACA with regards to coverage, cost-sharing, annual spending caps, and other metrics. Some of these plans are closing rather than conform to the law. But there is no blanket provision against high-deductible plans.

There are some suspiciously similar stories floating around the conserv-o-sphere involving vaguely specified elderly couples who are just spitting mad about having to give up their cheap, crappy, high-deductible plan because of the ACA. These stories smell very much like astro-turf propaganda, and should be treated with high levels of skepticism.

2 comments

Another thing that is happening is that some insurers are realizing that the individual plans they offered prior to the ACA (which they have to do all the work of acquisition/marketing, and whose potential client pools are limited compared to exchange-listed plans because no one is eligible for a subsidy to purchase them) are no longer competitive in the marketplace given ACA exchanges where: 1) A substantial part of the cost of marketing is subsidized by the public who provides a discovery portal, and 2) Lots of potential clients will be eligible for premium subsidies.

The net effect is that exchange-listed plans -- because of the two forms of subsidy -- have lower per member acquisition costs than traditional individual plans, meaning that for any given premium level, they can provide more profit and/or more coverage. These plans can expect to lose lots of their existing customers to exchange plans in the short-term, and its not really worth the effort to replace them -- so, for the insurer, it makes sense (especially since if they are also offering exchange listed plans) to just cancel the no-longer-viable non-exchange individual plans rather than continue to bear the fixed overhead of operating them when their sales prospects aren't good.

>>> No, high-deductible plans are not "illegal" under the ACA.

Of course, the mere fact that plan is high-deductible does not make it illegal. However, as far as I know, under ACA it is illegal to offer plans that restrict coverage of certain options. Which makes specific plans that were restricting them (and thus making the plans cheaper) illegal, and they are getting cancelled because of this.

>>> There are some suspiciously similar stories floating around the conserv-o-sphere involving vaguely specified elderly couples

I've personally seen multiple scans of officially looking letters saying things in the vein of "our insurance company discontinues this plan because of ACA". Are you saying all of these scans are fake and produced by astro-turf propaganda? To choose most "propagandy" one, just to get it out of the way, here's an example: http://michellemalkinblog.files.wordpress.com/2013/09/screen... This is from Michelle Malkin, google who it is if you don't know, it is a very real (though not that elderly) person. Is it true or fake?

As I said: some existing plans don't meet the requirements of the new law, and are being discontinued. It doesn't matter if I think your one cherry-picked example is fake, because, again, some plans are being discontinued.

Regardless, high-deductible plans are legal under the ACA.