[quote=no_such_reality]I get catastrophic type situations and chronic conditions, but it seems like any major employer plan is pushing $1500-$1800 per month for a family combined costs
Are families really racking up $20k in medical bills a year?
It seems like there should be a fairly cheap option where the individual pays the first $6500 of any expenses and then anything after that is covered. It doesn’t match bronze tier actuarial cost structure.
For a family structure it at $12k or $18k then 100% coverage. If your below 400% FPL give the money back on taxes.
Cut the billing bureaucracy which seems to be half of every doctors office I’ve been in recently. Literally there’s more people working the phones and insurance payments than treating people.[/quote]NSR, AFAIK, it has been law in all 50 states for at least the past 20 years to provide health coverage for one’s children. If that coverage was CHIP or “Healthy Families” and the parent(s) qualified for these programs, then that constituted “child coverage.” Every employer with 50 employees or more offered coverage for both an employee and their child(ren) because it was the the law, even before ACA.
Workers complaining of high premiums being deducted for medical insurance from their paychecks are obviously covering a spouse with a healthplan. The law does not require employers to cover a spouse’s medical premiums because it is presumed that every non-disabled adult is responsible for themselves. Some employers cover part of a spouse’s health premium as part of a comprehensive benefit pkg they offer employees but more and more employers in recent years will not offer to cover any of the spouse’s premium but still offer group coverage to employees’ spouses if the employee wants it.
If you or anyone else is paying the high premiums you describe here for “family coverage,” you really have nothing to complain about. It wouldn’t be fair to your single coworkers (parent or non-parent) if you rec’d a cash benefit for full coverage for two (expensive) adults and they didn’t get compensation to equalize their health benefits with yours. Every worker has the choice on whether to cover the spouse or have the spouse work enough hours to obtain their own coverage. It’s as it should be.
If the “family premiums” your employer is requiring you to pay cause your health premium deduction to be more than ~9.5% of your gross income and thus is “unaffordable,” then your spouse is certainly welcome to sign up for an exchange plan and possibly receive a “subsidy” to help them pay his/her monthly premium in lieu of working enough hours to receive their own coverage.
Yes, “families” can easily rack up $20K+ of medical expenses per year without any of them ever setting foot in an emergency room!
Yes, I agree about the large staffs needed today in medical offices to wade in the “billing bureaucracy.” That was the chief reason given in letters by my two longtime providers for “retiring” from practicing medicine after the advent of the ACA. It IS ridiculous that there are more humans working as billers for the typical 2-6 physician/PA medical office (both inside the office and contract workers) than there are actual medical providers in that same office.
