Republicans push high deductible plans and health savings accounts
Source: NPR
December 8, 2025 5:00 AM ET
Sarah Monroe once had a relatively comfortable middle-class life. She and her family lived in a neatly landscaped neighborhood near Cleveland. They had a six-figure income and health insurance through her job. Then, four years ago, when Monroe was pregnant with twin girls, something started to feel off.
"I kept having to come into the emergency room for fainting and other symptoms," recalled Monroe, 43, who works for an insurance company. The babies were fine. But after months of tests and hospital trips, Monroe was diagnosed with a potentially dangerous heart condition. It would be costly. Within a year, as she juggled a serious illness and a pair of newborns, Monroe was buried under more than $13,000 in medical debt.
Part of the reason: Like tens of millions of Americans, she had a high-deductible health plan. People with these plans typically pay thousands of dollars out of their own pockets before coverage kicks in. The plans, which have become common over the past two decades, are getting renewed attention thanks to President Donald Trump and his GOP allies in Congress. Many Republicans are reluctant to extend government subsidies that help cover patients' medical bills and insurance premiums through the Affordable Care Act.
And although GOP leaders have yet to coalesce around an alternative, several leading Republican lawmakers have proposed Americans who don't get insurance through an employer should get cash in a special health care account, paired with a high-deductible health plan. In such an arrangement, someone could choose a plan on an ACA marketplace that costs less per month but comes with an annual deductible that can top $7,000 for an individual plan. "A patient makes the decision," Sen. Bill Cassidy, R-La., said at a recent hearing. "It empowers the patient to lower the cost."
Read more: https://www.npr.org/sections/shots-health-news/2025/12/08/nx-s1-5629249/hsa-high-deductible-health-plan
That is their standard drivel and all they can think of trying to throw some shit together to "replace" something that took over A YEAR to craft.
The ACA's "Bronze Plans" already have "low premiums but HIGH DEDUCTIBLES", so what they are purportedly proposing is nothing new.
And right now, people don't even have enough to buy food and pay for their mortgage/rent/car (if they even have one), so there is no way they can put money in some "health savings account". That whole concept is a FAIL.
All they did was spend an entire year in 2009 - 2010 trying to kill the ACA and despite being required (by the PP ACA LAW) to be on it THEMSELVES (most likely with the top tier plans), they apparently have ZERO idea what options are already there. And at this point, it is a "health system" problem NOT an ACA problem with respect to the costs (and denials of care). The "bigger patient pool" is already lowering the cost and breaking that up will make it impossible for tens of millions to have health care at all except in the emergency rooms, where taxpayers often end up having to pay for that.
Walleye
(43,532 posts)To emergency rooms instead of their primary care doctors because so many people dont have insurance at all
Karma13612
(4,898 posts)People dont have access to primary care providers at all. The waiting list to join a practice in my area is 18 months. So, you are forced to go to an Urgent Care or ER. And many small practices are closing due to financial struggles and slashing of Medicaid.
So, It isnt just coverage, but the lack of health care professionals as well. I put Professionals in quotes because of the whole nasty crap about not designating certain members of the health care team as professionals.
All this is just going to keep getting worse.
patphil
(8,595 posts)Walleye
(43,532 posts)And so many Americans have no access to that
BumRushDaShow
(164,427 posts)because vulture capitalists came in, bought hospitals and created for-profit "hospital systems", milked every dime out of them, and then started closing them down left and right.
The few that were saved were absorbed by some of the area Universities but the rest are gone, the employees fired, and the buildings are up for sale.
Walleye
(43,532 posts)Its sobering when you realize that he wants more than half of the people in the country, because we didnt vote for him, to be absolutely miserable and does everything he can to make it happen. I really hope some of the other Republicans are paying attention to the way hes treating Marjorie. Its like she said they are terrified. She forgot to add they are also cowards.
travelingthrulife
(4,093 posts)High deductible plans are a joke. They appeal to lower income people because the premiums are low but they have to have thousands out of pocket before they can even access the insurance.
lastlib
(27,318 posts)Two parts:
1) don't get sick;
2) if you get sick, spend yourself into poverty, then die.
gab13by13
(30,902 posts)Even after the deductible is met procedures will be screened and choices of doctors will be limited. If one strays from the basic rules the insurance will only cover a % of the treatment even after the deductible is met.
It is happening to me next year with my prescription drugs, if I don't use mail order or use the prescribed drug insurance wants me to use, my insurance will only pay 25%.
Today I am paying 10 dollars a month for 5 mg Eliquis, next year I could end up paying 125 dollars a month.
raccoon
(32,167 posts)I hate Republicans.I hate Republicans.I hate Republicans.I hate Republicans.I hate Republicans.I hate Republicans.I hate Republicans.......
Ray Bruns
(5,881 posts)High deductible plans for morons who think they are getting insurance until they get the bill.
Nigrum Cattus
(1,155 posts)when you're sick, many times, you can't work.
therefore you can't earn the extra money you need to get well
greed never leads to anything good.
RicROC
(1,249 posts)The ACA plan is the Heritage Foundation Plan because the Repubs were being forced to come up with 'something' and Obama thought their health care plan would be a bipartisan slam-dunk. Turns out, Repubs have tried to cancel their own plan/ ACA ever since.
It's time for Universal Care with no copays. (NOT 'Medicare for All' because that does have copays and deductibles)
No long-term studies- just adopt another country's model. I understand Chile has well reviewed health care
Walleye
(43,532 posts)IronLionZion
(50,600 posts)dlk
(13,076 posts)And when the deductibles are sky high, medical care essentially becomes an out-of-pocket expense
patphil
(8,595 posts)All too often that number keeps going up and up into 6 figure territory.
No personal savings plan can prepare a family for that. And, a $7,000 deductible is already beyond most people.
The republicans are just putting forth the same old plan they have always offered up in a "we'll have it ready to show you in 2 weeks" format.
It's called We Don't Care.
progree
(12,653 posts)progree
(12,653 posts)no they are not. Their purpose is to stabilize the person and then it's out the door you go, with a fistful of prescriptions that you can't afford to fill, and references to specialists that you can't afford to see. They do not provide longer-term services like chemotherapy for example.
PSPS
(15,172 posts)Orrex
(66,518 posts)Although they insisted that they weren't trying to "sell" us on the high deductible plans, they talked about those plans for about 89.5 minutes.
ananda
(34,185 posts)For republicans it's always themselves
and their donors.
Attilatheblond
(8,022 posts)Win/Win for an industry that buys politicians.
NHvet
(268 posts)Much like the Medicare "advantage" plans with zero payments upfront but huge deductibles if you need the coverage. The only advantage is the Insurance company can make more money.
iemanja
(57,248 posts)LilElf70
(1,305 posts)Yeah, that's going to help a lot of people..... NOT!!!!!
I was on the ACA for years. I called it catastrophic insurance, not health care insurance. Unless you have a catastrophy, it's useless. No one can afford the insurance, nor the deductibles and co pays. And the republicant's want to make it worse? This is so fucked up!
IronLionZion
(50,600 posts)people hold off on treatment because they would have to pay for it. So it actually encourages problems to get expensive enough for coverage to kick in. By then it's often too late and insurance likes to deny coverage anyway. They make more profit if we die faster.
swong19104
(571 posts)HSAs, health savings accounts has got to be the stupidest and most vile policy idea.
Imagine having to create, maintain, and protect a huge savings account that has to be highly liquid, grow quickly, and not be volatile. There are no such investment vehicles that provide even two of the three.
Further, having a large savings account but no control on medical costs just allows the healthcare provider to charge whatever you have in the account. As you know, there is no price list when you enter a hospital or clinic. Is this injection $10? $50? $500? Do you have a choice after you receive the injection?
IronLionZion
(50,600 posts)because they get to collect exorbitant fees on our money and don't pay interest like a normal savings account. It's dirty.
Ol Janx Spirit
(537 posts)...for the already-fat buzzards circling over the carcass of their futures?
This is another all-too obvious ploy to further enrich their wealthy donors at the expense of what is actually good for the average American.
But this only happens because too many people are too easily manipulated into voting squarely against their own interests.
And the worst part of this latest plan by the Get Off my lawn Party is that it does nothing to encourage the proactive health habits and care that we know lowers costs for everyone.
But we've never had a "health" care system; just a "sick" care system. Just imagine how it could be if politicians actually cared about people more than they care about money....
undergrounddemsunite
(14 posts)How do we know this isn't another Wall Street trap? They already have our pension funds at their disposal. They bring the economy down and our money goes down with them.
Turbineguy
(39,728 posts)Somebody will no doubt set up a market where you can trade healthcare.
Figarosmom
(9,382 posts)Tax free savings accounts are the answer! People can't even seem to put $10. a week into savings so this must be the answer. And high deducts are already a problem even at like $250. A year.( which isn't really high just unaffordable to many)
slightlv
(7,227 posts)how in the hell do you add in healthcare, too? You either die for lack of healthcare or lack of food. I think the premise is... DIE! Unless you're rich, that is. Then, it's all laid out there for you, and you probably don't have to pay a dime depending on who you know. HSA are bullshit. They may be good for some over the counter stuff you need, or a small procedure. But no way are they going to do any damned good when you have a stroke or a heart attack. I detest the plan we're on right now with MA, but it's worked out to be the cheapest that covers the most for my hubby this year. Still, 300-350$ copay for a CTScan, and the same for the MRI on the brain his doc wanted. $200-250 each if we go to a free standing radiology place... not inside a hospital. I mean come on, not only are those prices outrageous when you looking at a 79 year old... but we have to FIND these places ourselves. The season just ended, and I'm still so mad I could spit nails.
I'm so mad at what they're doing... I want my hubby to get these scans so we can get a jump on any new meds or treatments out there for what they find. But he still has to eat. Dementia is already stealing my best friend.... and I'm just so mad, I WANT Mangione to get off with jury annulment, if nothing else. Just so these fat cats can see how we REALLY feel about them.
swong19104
(571 posts)First is where the first question asked isnt, What is your insurance carrier?
Second is there are no cash registers, credit card scanners, Venmo NFC readers anywhere in or around the premises.
Traildogbob
(12,343 posts)On a post here on DU earlier, they are going all in on cutting, even eliminating veteran disability payments
Calling it a theft from American tax payers.
Yet every VA visit, which has been many this past two years, MAGA hats and vehicle stickers are plentiful. I Past an idiot going out as I went in Friday with a trump 2028 hat. If I were not on scooter with an Achilles repair recently, I may have said what I felt.
They do NOT care if all none millionaires die,
Who are they gonna get to go die and get crippled in wars to steel resources? Who is gonna pay taxes for their salaries and health care, because all of them hold offices in the takeover of MurKKKa.
Christmas aint gonna be Merry and if ya think the New Year is gonna be Happy, please share what youre smoking, or eating in gummy form. (Both illegal soon) unless ex Hungarian President gets it into US.
🤶 🎅 🎄 🤗😵💫😡 War on and during Christmas.
Suck on that Kelly and with white Jesus and Satan, I mean Santa. Auto correct keeps changing Santa to Satan🤔 hmmm?
thought crime
(1,085 posts)tfury653
(8 posts)Call or email your Senators and Reps. Demand we, the people, get what they get for insurance. Health and pension. Also no one in congress will not be allowed to seek reelection if the budget is not within three percent of the GDP. We are getting sold down the river with these clowns. Until we make noise they won't pay attention