Their definition must not match mine.

My daughter's billed medical costs are $200,000 every single year. A higher deductible cost is often much cheaper for her than a "traditional health plan() with a lower deductible"

She will run through whatever out-of-pocket max her plan has. Typically a lower deductible plan costs more in premiums, whereas a higher deductible plan is cheaper. We choose her plan by adding the out of pocket max to the cost of premiums - because she will spend that every single year. That typically means a higher deductible plan is cheaper. It does pose timing changes - since she often hits her out of pocket max in January or February. But whoever wrote this has not truly experienced high medical costs.

(Note: I am NOT saying his idea is a good one. It will be disastrous for those with higher than average, but not extraordinary, costs. Just commenting that whoever wrote this has not experienced truly high medical costs on an ongoing basis.)

If a person can cover the high deductible as can your daughter then there would be no problem. But many living on the edge, but not qualifying for Medicaid may not.

The costs are the costs - whether she "can" pay them or not. And the overall medical cost for the year is lower on a high deductible plan for people who actually have high medical costs.

Example:

Monthly premiums for $10,000 deductible plan, with a $10,000 out of pocket max: $150/month.

Monthly premiums for $250 deductible plan with a $10,000 out of pocket max, and a 20% copay. (simplified for purposes of illustration): $500/month

Assume her $200,000 are spread evenly over the year (again, for illustration purposes) - $16,667/month

High deductible plan: $10,000 +$150 for January; $150/month the rest of the year. Total cost for the year = $11,800.
Low deductible plan: $500 + $250 + $3283.4 for January; $500 + $3333.40 for February, $500 + $3133.20 for March then $500 for April-December. Total cost for the year - $16,000

I never said she could afford it. Simply that she has no choice - it is what it costs to keep her alive. Given that (most of the time) she wants to live, a high deductible plan saves her $4,200 a year, in this simplified analysis based on numbers close to the options she has had over the years.

Yes, the pain is greater for a single month versus being spread over 3 months. but then her health care is essentially free for the remainder of a year.

My point is that whoever did this analysis does not understand the economic impact of high medical costs - or has never done the calculations to compare the overall costs of the two types of plans.

To be able to get the quality of Health insurance you actually need.
I need an HSA on top of an employer provided health insurance policy, where they also pick up at least 1/3 - 1/2 the cost of the policy because there's chronic health issues in my family.
If I were to pay for my own policy, I would be out $30k a year on premiums.
I'm lucky, I've worked my way into management and almost make 6 figures, and have secondary household income.
My neighbors, with lower service industry incomes subsidized on the ACA, have health issues in which they'd have to decide if the higher income working spouse with a heart condition continues to get treatment or they get a roof over their heads and at least two meals a day.
An HSA that gives them even as much as $5k per person won't cover half a year of the that person's health care, nor would it help them purchase any of the high risk plans they need to keep that spouse treated.

But...thinking about it, if Single Payer or Nationalized Healthcare is off the table, a HSA on top of their current subsidized ACA plan would really take the stress off them.
Just saying.

not a bad idea, if the Republicans are willing to spend money.

Starving already stressed parts of the social security net such as Social Security. Ultimately robbing mandated participants of their meager high three upon retirement. I suppose the fascists see this as a win-win.

Also typically the amounts participants have been able to scrape together and put away are exhausted before they even arrive at a hospital in a true health crisis.

Medicare for all! Now!

The HSA solution works for those who have enough money to pay their deductible and still be able to pad the HSA or low healthcare costs. But one surgery or major illness and the math flips.

Pre-existing conditions? Will people still get free preventive care? Cover your kids til age 26? How will it affect employer based insurance, if you’re lucky enough to have that?
Just extended the subsidies and be done with it, FFS. I think some of these new hare-brained ideas come from trump and his party absolutely refusing to compromise. After all this is the party that once declared “bipartisanship is date rape.”

don't allow you to carry over the money from year to year. It has to be spent.

if their scheme is a flat amount per person regardless of age, the people who need medical treatment are screwed while other money could be stuck in unused accounts for a while.