The deductibles on the ACA seem to be really high. My brothers is $10,000. Is that per year?

[Yo_Mama]

57. That's a two-person deductible.

ACA family out of pockets generally run around 12K. But the 70/30 silver split can be handled by any distribution of deductible and copayments, so they vary. The higher the deductible portion, the lower the premium.

In my home county in GA (Lowndes), for example, for a family with two kids, parents aged 50 and 52, non-smoking, there are various silver options, but the lowest premium is $1,445 a month and all the rest have monthly premiums above $1,500. But these are all real insurance - the highest premium has a $5,000 deductible, 10% coinsurance and an out-of-pocket maximum of $9,000, for a monthly premium of $1,568. The lowest has a $6,000 deductible, 10% coinsurance and an out-of-pocket maximum of $7,200 for $1,445 a month.

The lowest premium plan this family can buy on the exchange (and avoid the fine, I think) has a $986.00 monthly premium with a $12,700 deductible, no coinsurance. Once you pay $12,7000 in medical costs, the rest is paid for you. Coverages are of course the same. But $500 a month is $6,000 over the course of the year, so actually it makes financial sense to buy the "catastrophic" plan. If you do not have medical expenses you always come out ahead, and if you do you about break even. Plus, the money you save on premiums can be used to pay your medical costs.

The bronze plans have family deductibles of over 10K.

Higher income families without the subsidy will only be able to buy bronze or catastrophic policies.

If this same family had an income of 70K rather than 95K, they would be able to get the best silver plan ($1,568 base premium) for $608 a month. A lot of people with their own businesses and families are just going to stop making as much, to be honest with you. Between the taxes and the higher premium cost, it pays you to work less.

Cost-sharing kicks in at lower incomes and drops the deductibles and copayments.