Why can't I get a HSA-compatible ACA marketplace health plan any more?

November 7, 2024 12:49 PM

I am self-employed and currently get my insurance through the ACA marketplace (healthcare.gov). For the last 4 years I have used a High Deductible plan that is compatible with an HSA I carried over from a previous job. But Blue Cross is no longer offering this plan for some reason and I don't know what to do for my health insurance next year. Does anyone have any information or advice?

I live in Raleigh, North Carolina and have been using a "Blue Home Bronze HSA Eligible with UNC Health Alliance" plan for the last few years which is okay but not great. But, BCBS has canceled this plan and my auto renewal plan is a similar Blue Home Bronze Basic plan that looks the same except is not compatible with my Health Savings Account. I confirmed that it is the same level of care and has a high deductible, but their pamphlet makes it clear that it is no longer legally considered a High Deductible plan. Did something change this year where it would be in the insurer's best interest to not offer an HSA plan on the marketplace?

The pamphlet they sent me claimed I could sign up for a "Bronze HSA Off Exchange plan" but when I followed the instructions it was not one of the available plans on the BCBS website. I sent them a secure message asking why, but got a very generic and useless "you have to use Healthcare.gov" response. Does anyone have experience purchasing a personal off-exchange plan with BCBS? Do I have to call the right office to somehow purchase it?

The only plan with HSA support on the marketplace this year is Aetna and I've heard bad things about their coverage and policies so I don't particularly want to switch. I could go to the non-HSA BCBS plan but it will end up being much more expensive for tax reasons. I'm not sure what I want to do about my insurance next year, so if anyone has info that might help out I would appreciate it. Speculation is fine as it's very hard to get real information on the marketplace plans.

posted by JZig to Health & Fitness (2 answers total)

The IRS adjusts the definition of an HSA qualified high deductible plan annually.

For calendar year 2025, a “high deductible health
plan” is defined under § 223(c)(2)(A) as a health plan with an annual deductible that is
not less than $1,650 for self-only coverage or $3,300 for family coverage, and for which
the annual out-of-pocket expenses (deductibles, co-payments, and other amounts, but
not premiums) do not exceed $8,300 for self-only coverage or $16,600 for family
coverage.

An HSA qualified HDHP also can't have co-pays for office visits, etc.

That said, this only means that you can't contribute to an HSA while you're enrolled in that plan. You can spend your existing HSA money on appropriate medical expenses no matter what coverage you have.
posted by phunniemee at 1:51 PM on November 7

Response by poster: Yes, in my case the new plan has deductibles and max out of pocket that still qualify, but they added small copays for doctor's visits so it's not technically an HDHP. I've never actually hit my deductible so the copays are irrelevant. I guess the most likely answer to "why" is that they didn't want to deal with administrating an HDHP plan, but from the outside it doesn't seem like an HDHP is more expensive to administrate than the one that is the same but with small copays. I will definitely still spend out of my HSA either way but the tax deduction on contributions was very helpful.
posted by JZig at 3:24 PM on November 7