Aaronontheweb

Moving away from RSS was a mistake

Do you have non-ACA insurance? One explanation for why your costs are so much higher than the national average is that you're on a non-complying plan (you can also still buy plans that will exclude preexisting conditions --- they just can't be sold on the ACA marketplace). I'm pretty confident KFF isn't making these numbers up.

Asked and answered in the piece dude - I wish I had the confidence of a Hacker News commenter who didn't read the article.

I can assure you they are, if anything, understated - as I am not including the expenses my health insurance will not cover. So no, you are fully in the wrong there. What do I have to do to prove it? Show you itemized receipts?

Moreover, what are you even trying to accomplish by asking for this? Please provide me with a forthright defense of the modern U.S. health insurance markets and why it makes sense for me to have to pay this much to keep our population above replacement level.

That's not what the link the OP included said and not what I said either, but I concede your point - that's my fault for checking individual health care marketplaces (like eHealthInsurance and Aetna direct) or not looking closely enough on healthcare.gov.

Looking through some plans now, but TBH these are genuinely not much of an improvement in the cost department and a massive downgrade in the provider selection department. Hence my whole section on trade-offs.

Dude, you don't even have your own facts straight and you are embarrassing yourself. It's clear you have no experience, don't understand your own sources you provided, or any clue how child birth actually works from a medical billing standpoint.

Edit: what do I have to gain from spreading "misinformation?" I just want better / more options?

ACA plans absolutely cover childbirth (https://www.healthcare.gov/what-if-im-pregnant-or-plan-to-ge...)

that link doesn't even say what you says it does - it said you can apply for coverage, not that there are plans that cover child birth. Have you never done this before?

the $14300 is the family out of pocket max

You know they charge you, separately, for both the mother's care AND the infant's during a delivery right? Those count as two people. I am, with 100% certainty, going to hit the out of pocket max - I have every time.

Like I've paid for three kids all on the same plan, including one born in January so my deductible got spread over two different billing years.

I have to ask - why are you defending this?

1. I mentioned, in multiple places, that this is the cheapest PPO offered to me through a limited selection of potential brokers / marketplaces - and that's important because it covers our current health care providers AND child birth as a benefit.

2. If we weren't trying to have kids, our options for purchasing health insurance expand drastically. Individual marketplace plans become a viable, for instance, since the "not covering childbirth" issue goes away. I mention the short-comings of the individual health insurance marketplace at least twice in this regard, including a big pull quote explaining the ACA work-around with child birth coverage.

The explanation of benefits simply doesn't cover child birth - this is extremely common for individual marketplace plans.

Given he has 3 children, 400% of FPL in 2026 is $150,600 so he's easily eligible for ACA subsidies

I am absolutely not eligible. I earn more than $150k. And "manipulating your income" is not really feasible with a pass-through entity.

The premiums have nothing to do with the plans. Every single plan on the marketplace has to cover child-birth, that's sort of the point of the ACA.

As I mention in the piece, I check every year. I have no idea what subsidized plans include, but the other marketplace plans definitely do not include child birth.

I explicitly address this point:

The Affordable Care Act (Obamacare) barred insurers from turning down applicants based on existing pre-conditions; the way insurers get around this for pregnancy and child-birth is not by rejecting pregnant applicants (illegal), but by simply refusing to cover the care those applicants need to survive pregnancy (legal and common.)

and

My wife and I are healthy, but we’re building our family and I have yet to see a marketplace plan that supports child-birth. Maybe the subsidized ones do, but I earn too much money to see those. All of the ones I’ve found through eHealth Insurance or Healthcare.gov never cover it - and I check every year.

Love the over-confidence though. The best outcome for me in even writing this article would be to get some internet commenter pissed off enough to find me a cheaper version of my plan. That would solve my problem immediately!

I included screenshots of my actual health insurance premium terms, including the plan number, which is what is at issue in the article.

Did you try reading the lengthy section of the article where I answered your question?

It sounds like you're trying to communicate that you pay at least $200/month per smartphone for your family? Or you don't value precision in communication.

You're moving the goal posts here. You have to have service, realistically, in order to use it like a real person.

I pay that at least much for my family, hence why I used it

I'm right there with you - this is a case study in "perverse incentives." There is zero benefit to "paying into the system" to be had under the current model. Better to chance it and then sign up for a plan at the last minute since insurers can't deny you based on pre-conditions.

I think the market can do a better job of optimizing than central planning ever can - the problem is we have both the costs of capitalism and socialism concurrently with the model we have now. A worst of both worlds scenario.

I actually thought about including this in the piece (and how car sizes become a problem once you hit 4+ kids) but decided to keep it more focused on just the healthcare costs

My wife had to have an emergency C-section the first time around when they lost the heartbeat on our first baby, so we've stuck with planned C-sections - so yes, we are somewhat constrained in terms of our choices there.

I only keep this plan because we're planning on having children, so yes, it's included in the pricing decision.

Massive government subsidies for health care consumption not only eliminate, but disincentivize price discovery. If your biggest consumers of health care (seniors) have access to the best health insurance plan in the world (Medicare), that's going to drive costs up

Completely removing the U.S. Government from the health care market (Medicare, Medicaid, Obamacare, uncompensated care, etc) would be a great start.

I've discussed just opting out of health insurance altogether and doing CrowdHealth with my wife, thinking along these same lines.

To be fair, that's because their own Azure.Identity org hadn't even shipped an update addressing this vulnerability and they work in the same building.

We'll see how "sell AI itself as a feature" rather than building actually useful features with AI works.

not because of liquidity problems.

The liquidity problems caused the flight - why else would they take a $1.8b haircut on a securities portfolio and then try a bone-headed cap raise to cover the difference?

SVB's liquidity problems were known for months because they were a function of interest rates and failure to manage interest rate risk on their part - besides, the CEO was on the board of the SF Fed. It's not like they weren't in communication with other banks about what's going on with the markets and the Fed itself.

Not really - rewriting the rules (FDIC insurance limits) midway through because SVB's own depositors yelled "bank run!" loud enough is still moral hazard. Do I need to make sure I bank with an institution that Jason Calcanis, Mark Cuban, et al use so I can insure my deposits with their political / popular leverage?

That's if you ignore the secondary effects: "moral hazard," knowing that if you become big enough to create political waves in the event that you fail you can continue to gamble with depositor money, make your annual bonus, and safely be rescued by Federal depositor backstop / bailout in the event that you eventually go tits up. I wonder if that'll ever happen again after 2008...

That $5b is definitely "insured" - the FDIC has all but nationalized US Bank deposits so long as there's widespread liquidity issues under its "systemic risk exception."

So why didn't these same banks band together and buy out SVB / its assets instead of letting it file chapter 11? Wouldn't have preventing the 2nd and 3rd biggest bank failures in U.S. history happen within a few days of each other been a much better way of preventing future regulation?