Plan A: $2,000 deductible
Plan B: $400 deductible and coinsurance
Plan C: $0 deductible and coinsurance
C,B,A is how the plan designs rank in terms of deductible attractiveness.
Kaiser Family Foundation current messaging is deductible focused.
Under the ACA people with incomes up to 150% of poverty pay an average deductible of $255. In the Senate hill bill it would be over $6,000. pic.twitter.com/UEX7WFPRqG
— Larry Levitt (@larry_levitt) June 24, 2017
But is deductible the number to look at?
It really depends, the best number to look at is the actuarial value. The three plans are 81%, 71% and 70% AV.
Plan A is the gold plan at 81% actuarial value. The $400 deductible Silver is slightly richer in benefits at 71% actuarial value than the no deductible Silver. Both B and C have a 60% coinsurance. Plan B has 60% coinsurance with a $5,500 maximum out of pocket (MOOP). Plan C has no deductible but a 60% coinsurance to a MOOP of $7,150.
Plan C is the worse plan for anyone who spends a night in a hospital. They bear the largest proportion of the total pool’s cost sharing obligations. For the same actuarial value, higher deductibles advantage sicker individuals while more co-pays and coinsurance advantages people with minimal utilization.
We need to sharpen our thinking and our language. Deductibles are an easily number that can be readily gamed. I think the combination of maximum out of pocket exposure and actuarial value are the numbers that actually need to be communicated in a seven pitch as those can’t be as readily messed with.