Mac1958
Diamond Member
It's correct that you don't have to contribute to your HSA, thereby leaving yourself (or the hospital) at risk for your deductible. But that goes against the spirit of the plan, especially when the GOP pretends an HSA is the answer to our health care problems. People can't afford both sides to these plans. And anyone who thinks they're not paying for the health care of those who can't afford it is dreaming.The HDHP deductible is directly relational to the amount you're contributing to your HSA account. That's the whole point, unless you're going to write a check for your deductible, which most people can't do.Good.I'm the average Republican, and I'll be happy to explain HSAs - as they REALLY work, not as liberals want to portray them.Ask the average Republican to explain an HSA, and how it makes health care more accessible or affordable.
They can't.
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HSAs are a savings/investment vehicle in order to offset the first-dollar costs of healthcare.
1. An HSA is funded with pre-tax dollars (you don't pay taxes on the money put in it). That is an automatic 15% (or so) return on your investment. The maximum amount of tax-free money you can contribute to the HSA is $3350 (single) or $6100 (family) per year. You may, however, put as much post-tax money into an HSA as you wish.
2. The money put into an HSA is invested (as defined by the individual - you get to choose the investment vehicle) in order to gain a return on the money. If we assume an average of 5% return on your investment (a very reasonable expectation), your return on investment (ROI) is now 20%. You have cut the cost of your deductible by 20% (you're actually using money you earned from investing, plus the taxes you didn't pay).
3. If you put money into an HSA and don't use it, you can rollover the money (tax-free) into the next fiscal year. The money remains tax-free as long as it is in the HSA.
4. If you take money out of the HSA to cover healthcare costs, it remains tax free (as does any ROI you made).
5. If you take money out of the HSA (yes, you can do that) for some non-medical reason (you want to buy a new car), you must pay taxes on the money.
This program is especially attractive to young people/couples - those who have a reasonable expectation of low medical costs.
The national average for the cost of $5,000 deductible health insurance for a 20 year old is $1,050/year, while it is about $4,000/year for a 40 year old. So, a reasonable program for a 20 year old would be about $100/month for insurance, and $100/month into an HSA. After about 4 years, the HSA will be total-funded for a deductible of $5,000, and the $100/month investment can be transitioned to offset the increasing cost of insurance (because of increasing age).
It ain't rocket surgery, folks.
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Oh, by the way .... if a young person (under 26) uses an HSA and a catastrophic healthcare policy, it actually can be cheaper than being a rider on Dad's policy (since Dad's rates are pro-rated based on HIS age, and the rider is a percentage of Dad's rate). The "until 26" Obamacare rider was actually a sop to insurance companies because they got money to cover people who probably wouldn't have bothered to cover themselves. But, you never hear that from liberals, do you?
So you have two parts of this plan into which you have to pay: An HDHP (High Deductible Health Plan) and your HSA, which is essentially a "medical IRA" account. For a typical family of four, that may be, say, $600 a month. Then you have to contribute to your HSA. For a $6,100 deductible, that's another $500 per month.
So if you don't have the money to contribute into your HSA on top of your health care plan premium, you won't have money to pay your deductible. Hospitals have long since figured this out, so they are now demanding payment of your deductible before they render significant care.
How does this make your health care more affordable or accessible?
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First, you fail to understand the significant DECREASE in cost when you transition from an ACA insurance program to a HDHP. The saving will be significant - depending on your age. The reason for this is simple - YOU get to decide what coverage you want. You will not be paying for programs you don't want - i.e., birth control, end-of-life planning, Planned Parenthood, etc., etc., etc. You get a program tailored to you - and you aren't funding free contraceptives for college co-eds, morning after pills, exercise programs for old people, pedicures for diabetics, etc.
The $6,100 you so blithely quote isn't a deductible - it is the maximum tax-deductible contribution to the HSA for a family.
But, let's take what I think you meant - let's assume you have a $5,000 deductible HDCP policy - you are not REQUIRED to fund the entire deductible in the HSA. You can choose to fund $2500 in the HSA (keep in mind that''s actually only about $2150 in actual net income - the rest is tax saved), and be ready to fund the additional $2500 out of pocket in the event you have medical costs. At the end of 2 years, you may choose to never pay into the HSA again, and just have it there in case. In reality, you'll probably fund it at a much lower level, as a hedge against multiple catastrophic events.
While we all realize that a medical catastrophe is possible in Year 1, it is highly unlikely. If it doesn't happen, the $2500 you put in the HSA is now available to be added to the $2500 from Year 2.
Take a realistic look at your ACTUAL health care costs for the past 5 years - that should be your planning target. If you have have an expectation of a catastrophic health incident in the next 5 years, tailor your HDCP accordingly. If you haven't, the same applies.
Is healthcare free? No. Can it be managed? Yes.
It is not an all-or-nothing program.
If you're healthy and you don't access your HSA for deductibles, great. The amount grows tax-deferred and will be available for retirement income. But if you're not healthy, or if shit just happens, you have to keep contributing.
The word just came out today that more than half the country can't write a check for $500. And we're expecting Americans to pay for both an HDHP and an HSA? This just simply is not realistic.
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Half the knowledge, my friend --- half the knowledge.
The amount contributed into an HSA is NOT driven by the size of the deductible of your HDHP, nor vice versa. You can buy a HDHP and make no contribution to an HSA whatsoever. Further, you do not have to "keep contributing". You control the size, duration, and rhythm of your HSA contributions.
I have heard there are products out there that tie the two together - but they are trying to take advantage of your ignorance. If your insurance specialist tells you that you MUST buy a linked product, get a new insurance specialist.
Also, your assumption that you must cover all the deductible isn't exactly true, either. Some private hospitals may require an up-front payment, or verification that your deductibles have been previously covered, but most doctors or hospitals don't. This may happen for routine care, but not usually. For catastrophic care? Never.
Think of it this way ---- you have had a catastrophic incident. The hospital can NOT refuse you service (by law). You have a HDCP that covers everything above $10,000 and about $2500 in your HSA against what is going to be a $100,000 medical bill. Do you seriously believe they are going to turn you away? They will take the $92,500 and work with you for the remaining.
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