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Comment by John23832 | Hacker News Reader

The ACA didn't do away with HSAs.

ACA didn't do away with HSAs, but the way the Bronze and Catastrophic plans were designed made them incompatible with HSAs. Only this year was that changed. The plans covered certain non-preventive services before the deductible was met, which was not permitted under older HSA rules. It was really dumb, and took 15 years to fix.

Agreed. Upon passage of the ACA my company switched insurance coverage to a High Deductible plan with an HSA. So if anything, the ACA appeared to increase the prevalence of HSA's. But that is my narrow social circle and the grandparent poster seems to have a different experience.

Correct, instead it made them unaffordable and disappeared them out of existence. Previously to ACA, I paid $280/month for a direct (non-employer sponsored) plan that had a $5k deductible. The plan was discontinued as the base fell out.

There is so much wrong with ACA and the hardliners are not capable of self-reflection, and cannot admit that overregulation has done nothing but make things incredibly expensive.

do you have anything to say about the fact that before Obamacare, pre-existing conditions were generally not covered? to me that is the main purpose of Obamacare. I think not covering pre-existing conditions is a moral atrocity.

Why does everyone thing that the "one thing" Obamacare did was pre-existing conditions? That is a footnote in the grand scheme of paperwork in unloaded on health insurers. It's one tiny straw in a hayfield of regulations.

Insurance middle-men have made healthcare expensive. That has nothing to do with the ACA.

I was about to chime in. I still have a HSA? Something interesting is that the ACA was probably making normal people's insurance cheaper because for people with the Medicaid plans were specifically targeted for aggressive coding knowing that the taxpayer was footing the bill

It really does baffle me that the USA continues to subvert "socialism" by taking socialist programs and painting them with a capitalist brush^[1] and creating a worse result for everyone involved. It is the peak of government inefficiency

1: eg: fanny mae, The VA, Medicaid, The Federal Reserve....

Ah, but don't you know? Socialism is evil! Capitalism is GOD and is perfect!

- Republicans pretty much everywhere in the US

Seriously. This is pretty much why single-payer/universal healthcare systems aren't available in the US. It's also why UBI has never been tried. I'm sure someone is going to come in and say that I'm painting an overly-simplistic picture, but we seriously do have people still thinking that people willingly come to the US for healthcare because every other healthcare system is supposedly worse in every imaginable way (which somehow magically proves that what we have is better).

Honestly, I don't think the USA does a terrible job at managing these systems it's just funny to me how the song and dance pretend is such a thin facade. Something like UBI is too idealistic and out of reach for policymakers until the USA moves away from the concept that if you are poor, you are inherently evil.

Really all the USA needs to do is make a fork of the VA healthcare and fix the rough-around-the-edges and start offering it as a well-controlled attractive option in the market that is taxpayer funded, maybe roll it out for union workers and blue collared folk first for maximum political appeal

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