Republicans push high deductible plans and health savings accounts [View all]

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

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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.