Health-Care Forecast

After a decade in the health-insurance business, this is how I see Obamacare’s death spiral will unfold. Look forward to a repeal of the Affordable Care Act as soon as February. They propose to keep a few provisions like guaranteeing sick people coverage and being able to stay on your parent’s plan until you are 26, but the mandate would go away — you won’t be required to buy health insurance, and there will be no penalty. Rather than be subsidized, you’ll now be given tax deduction, which we all know isn’t a dollar-per-dollar trade off. You’ll now have to pay the entire premium and wait for 2018 to file your taxes.

They plan to return to market forces. There will no longer be a one-size-fits-all–type policies. It will be somewhat like the pre-Obamacare market where you’ll be able to buy slimmed down policies with high deductibles and limited coverage.

They will tout HSAs (health saving accounts), which are a good thing for young people who make a lot of money, but not much for others. In addition to the premium, which will only be slightly lower than a comprehensive plan’s, you’ll have to put another $300 if single and $550 for a family of four each month into an account. This is not only a more expensive way to go but also leaves your neck out the first year, because you will take on a $5,000 deducible per person. Accident plans and critical illness plans will be necessary to offset this; still another added expense. Many HSAs will go unfunded, just as before.