New A.C.A. Plans Could Increase Family Deductibles to $31,000, The New York Times, Feb. 26, 2026, by Reed Abelson
The Trump administrationās proposed new rules for Obamacare plans next year would shift more health care costs to Americans, with much higher deductibles that could lead to greater medical bills.
Under the proposal, people who rely on the Affordable Care Act for their health insurance coverage could choose plans with much lower monthly premiums. But that could leave them exposed to medical expenses totaling thousands of dollars more than A.C.A. plans do now before their insurance would kick in.
Dr. Mehmet Ozās new proposal would allow one kind of health plan to raise the annual deductible to more than $15,000 for an individual and $31,000 for a family.
The proposal involves a type of plan known as a catastrophic or skinny policies. Amitabh Chandra, a Harvard health economist who has studied high-deductible plans, said, āItās going to be a really cheap product that nobody wants.ā
āThereās no doubt that we have an affordability crisis. As we move forward to shifting more of the burden to patients, thereās a chance to really exacerbate the crises,ā said Dr. Joseph R. Betancourt, the president of the Commonwealth Fund.
The proposal could also erode other consumer protections. Overall, the rules could result in up to two million people dropping coverage in 2027, according to the administrationās own estimates.
Selected quotes from the NYT reader comments:
- āThis wonāt work without price controls for health care, which is best achieved by a universal health care system run by the government.ā
- āā¦it is time for universal health care.ā
- āGrow up USA ā figure out how to do a nationalized health care.ā
- āMedicare for All please.ā
- āā we need UNIVERSAL HEALTH CARE.ā
- āAmerica desperately needs universal health care.ā
- āCanāt we just provide single payer health careā¦ā
- āThereās no winning the health insurance battle until we get universal health care.ā
- āWhy not look at other countries that have universal health care and build our own similar system?ā
- āMedicare for All, now.ā
- āIām a 75 year old retired Canadian who hasnāt paid out of pocket for any of my medical care and several surgeries over the years. Health care in my opinion is a human right.ā
Comment:
By Don McCanne, M.D.
What is the leading health care concern in the United States? It is high costs + high deductibles + copays, which translates to ā¦ unaffordability and family economic risk.
Those least worried are the wealthy who comfortably pay for quality health plans and out-of-pocket costs. Also, those of us who remain healthy and donāt require much care are generally protected from growing personal expenses, though we all still pay taxes for public programs, such as Medicare, Medicaid, and the VA. Plus there is no guarantee that the healthy wonāt eventually face truly expensive medical problems. In fact, thatās a likelihood.
The very poor may be eligible for public programs such as Medicaid. However, this is no longer assured, with recent federal cuts to coverage for the near-poor. Also: some states have declined federal funds for state Medicaid programs, and some areas lack providers who are willing to accept Medicaid. On top of this, Medicaid often underfunds essential health care services, shifting costs to the rest of us.
Moderate-income individuals and families may have employer-sponsored plans, but these costs are paid for by reductions in salaries. The costs of premiums, deductibles, and copays continue to increase. As workplace plans became less affordable, many were able to obtain plans through the Affordable Care Act. Government subsidies, especially during the Covid pandemic, made these plans more affordable. However, recently Congress split in continued support of the subsidies, and they were allowed to expire. Millions are losing ACA insurance simply because they canāt afford the premiums and cost-sharing. Thus we have an increasing crisis in the funding of health care.
Since it was primarily the Republicans who ended the COVID ACA subsidies, we should ask about their proposals to address this funding problem. However, they have been quite vague on what they do propose. President Trump mentioned very modest cash distributions to citizens so that they can place their funds in health savings accounts and use them to purchase their own insurance plans or pay for care directly. Any reasonable analysis of this proposal shows that it would be grossly inadequate to pay for the health care of anyone with significant needs. Thus, it would defeat the concept of health insurance ā pooling funds to make essential, expensive health care accessible to those who need it.
This latest ACA scheme, from Dr. Oz and colleagues, would greatly increase the deductible before care is paid for. This would force funding of most routine care to come out of the pockets of most Americans ā mainly individuals with low and moderate incomes. The proposed amount for the deductible for a family would be $31,000. With all other essential costs rising, how would $31,000 be handled by a family with an income of, say, $60,000? We already have the tragic answer to that: severe financial hardship and bankruptcy.
Keep in mind that a universal health care system funded with equitable, progressive taxes does not produce financial hardship for anyone.
People increasingly understand the need for broad reform. Many readers responding to the NYT article advocate for universal health care. Recent polls indicate that a clear majority support Medicare for All, especially among Democrats, but also increasingly among Independents and even Republicans. Truly, what Republican wants to see a child in bankruptcy court because a beloved grandchild was unfortunate enough to develop a serious and expensive disorder? Even $31,000 for a young family that is launching its blissful voyage through life can be a profound hardship. Surely we can agree on a program that will take care of all of us!
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