An article in WaPo explains McCain's plan for healthcare. Everyone's heard of how he's super hyped about HSAs and individual plans, but not about his plan for chronic patients. The plan that seems to be in focus for them is the MCHA, a Minnesota insurer-of-last-resort.
HSAs are interesting, unless you've got a high-cost chronic condition. A employee making $28,000 with a spouse would pay 17% of their income on an HSA vs the 'standard' plan at 10%. With kids the percentage moves up another 3 percent for each plan. If HSA were the only choice a low paid worker with kids and chronic illness would be paying 20% of their income to keep themselves, a spouse, or a child alive. In exceptional cases HSAs are not a solution.
Of course, at my income without kids we're talking about the difference of 4.1% to 6.8%, but the services would be the same. HSAs are simply not an efficient way to insure someone with chronic illness.
MCHA rates for a chronically ill spouse along with an HSA for healthy kids and employee would be 21% of a 28k employee's income. Not all of it would be non-taxable either. MCHA does not enable an HSA to be an effective plan, either. Sure, with healthy kids and employee a savings may develop, but they aren't going to make up for the 11% hole in income, either. ~$3000 would do better on its own than locked up in a HSA.
In our particular case, even without kids, the MCHA+HSA situation still runs at 7.6% of income. MCHA was not designed to be a cost effective way to insure chronically ill people.
Even with the huge rates MCHA charges it loses money, 150 million dollars this year. Chronic patents shouldn't have to scrape up more than their fair share of money and require additional subsidy from the government when so much of our GDP is already dedicated to healthcare costs. McCain is touting a government subsidy (! one step away from single payer) program for these high risk pools. Why should high-risk, chronically ill patients be subjected to what the right calls as evil government controlled healthcare?
I'm also completely confused by the WaPo's take on Obama, missing out the risk equalization for high-risk preexisting conditions policies.
