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View Diary: Obama administration petitions Supreme Court to hear health care lawsuit (85 comments)

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  •  If 8% of your income is a problem, then you are (0+ / 0-)

    probably poor enough to qualify for the subsidies.

    Also -the insurance offered in the pool are all mandated to have certain benefits and services. Junk insurance will not qualify for the insurance pool.

    •  Insurance with a 60% actuarial value (0+ / 0-)

      which the ACA allows, most certainly is junk insurance.

      •  Actuarial value doesn't mean what you think it (1+ / 0-)
        Recommended by:
        anonevent

        means. It does NOT mean that if you got into a car wreck and racked up a $400,000 hospital bill, then you'd have to pay $160,000 out of pocket.

        Actuarial value means that across the entire population of that 60% plan participants, the insurer would cover 60% of the medical expenses and the insured would pay 40%. Keep in mind that the great majority of people do not have major medical expenses in an average year. Their medical expenses are actually far lower than their insurance premiums. There are only a small minority with significant expenses, and a very small minority who incur catastrophic bills. Higher actuarial value simply means that the upfront costs are higher for everyone. It doesn't (necessarily) mean that in case of a catastrophic illness you have to pony up 40% of hospital bills.

        In any event, all of the plans have out of pocket maximums. And there is also a sliding scale cost-sharing cap such that lower income people will have less cost sharing burden than higher income people on the same plan.

        •  I know exactly what actuarial value means (0+ / 0-)

          And with 60% actuarial value, you're looking at deductibles/out-of-pocket costs of around $6000-6500. That's junk insurance.

          •  Actually the max out-of-pocket is capped at $5000 (0+ / 0-)

            I believe the deductible is capped at $1500. The cost-sharing, as I already said- is on a sliding scale depending on your income.

            It's meant to protect you against a catastrophic illness. Is that junk to you?

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