1. United States
2. Ohio
3. Letter

I urge you to oppose proposals replacing Affordable Care Act subsidies with health savings accounts paired with high-deductible health plans and instead support extending ACA subsidies that protect low-income families from devastating medical debt. The high-deductible model has failed to achieve its promised goals. Despite widespread adoption over two decades, medical prices have skyrocketed rather than declined. The average knee replacement cost increased 74% from 2003 to 2016, more than double the overall inflation rate. Average deductibles for job-based coverage have risen from around $300 in 2006 to nearly $1,700 today, forcing families to pay thousands out-of-pocket before coverage begins. This system is causing real harm to insured Americans. About 100 million people in the U.S. currently carry health care debt according to a 2022 survey, and most are insured. Sarah Monroe, a 43-year-old insurance worker from Cleveland, accumulated over $13,000 in medical debt despite having health insurance when she developed a heart condition during her pregnancy with twins. Her health savings account never accumulated enough to cover major medical expenses. Her family lost their home, drained their savings, had their car repossessed, and suffered damaged credit. The premise that patients can shop for better prices is fundamentally flawed. Researchers at the Health Care Cost Institute found only 7% of total health care spending for Americans with job-based coverage was for services that could realistically be shopped for. Dr. Fumiko Chino's research on over 8,000 cancer patients at MD Anderson Cancer Center found that those with high-deductible health insurance were more likely to die than similar patients without such coverage. Expanding this failed model through health savings accounts will push more families into financial ruin. I ask you to protect constituents by extending ACA subsidies that make comprehensive coverage affordable rather than shifting costs onto patients least able to bear them.