Here are the results for plans for my wife and me from Blue Cross-Blue Shield.
This being the case, the market force at play within Obamacare is one that should be driving all the young, healthy people onto low-premium, high deductible "Bronze" level plans, that they can tie to a Health Savings Account.
And so my question is, what happens then to the structure of this program?
If everyone who is healthy enough to forego a "maintenance" insurance plan chooses to do so (and why wouldn't they?), my early assumption has to be that the insurance industry will be unable to support the older sicker people based on the lack of premium revenue. The whole idea here was to force everyone to buy insurance, raise premiums, and use the higher premiums on healthy people to pay for sicker peoples' maintenance insurance. But if younger people in general go the route of paying the bare minimum into the insurance pool as possible, instead contributing to their own HSA accounts, and the deductibles be damned, doesn't this eventually pull just as big of a Jenga piece out from the foundational levels of the scheme as people just not signing up anyway?
I do recognize that the more immediate problems with the system, such as not being able to sign up, and having no real financial reason to sign up due to the extremely low penalty, are likely to drive this train off the rails much sooner than my scenario. However, I also think that my scenario is another one that dooms this system as well. Ironically, however, taken to the next logical step in the long view, the market response would be to increase deductibles further, meaning that people would be much, much more inclined to begin actually shopping for their healthcare, rather than just showing up and expecting to be serviced for no charge, meaning that in the long run, prices to the consumer might actually come down as the healthcare industry would finally again be required to service the consumer rather than throw a fat bill at the insurance company's wall to see what sticks. Over the long term, proponents might actually trumpet to the heavens that the program has worked!
But I wouldn't give our government the credit for such foresight or patience as to wait for all of that to come to fruition. If they had the foresight or patience for that, they'd have simply written a program that majorly incentivized people to get onto HSA's, and opened up the insurance markets across state lines, giving people more freedom and choice. But the government response to a market response of insurance prices going up will surely be one instead of further control, perhaps to put some kind of fiat cap on deductibles, and eliminate HSA eligible plans, putting us all on more expensive maintenance insurance, leading to the necessity to increase the subsidy to lower income citizens, or perhaps even broadening the criteria for acceptance onto Medicaid (which is already looming large as a major wrench in the works).
Ultimately, this would also mean the healthcare industry will continue to overcharge for services, since there will continue to be no price feedback from the actual consumer.