So if I get cancer, my $200k bill (just to start, cancer treatment can go on and on) is still a $60k bill. I'm still bankrupt.
The plans all have maximum annual out-of-pocket expense caps, above which you get 100% coverage, so it wouldn't be nearly as high as $60k. Checking the website, the out-of-pocket expense for the California Bronze plan is limited to $6,350/yr for an individual, or $12,700/yr for a family. This is precisely so that you can have a finite exposure that can be self-insured by keeping savings in an account.
So in your example, if you were on a family plan and hospitalized, you'd pay the first $5,000 entirely out of pocket (the Bronze-plan deductible). Then you'd pay 30% of the next ~$25,650 in expenses (~$7700), which would bring your out-of-pocket expenses for the year up to $12,700. At that point you've hit your out-of-pocket cap, so if there are still bills past $30,650, the plan would cover the entirety of the remainder.
The Bronze plan is essentially a high-deductible plan, but with the partial-coverage in between zone: you pay everything below $5,000, and nothing above $6,350/$12,700. The minor exception is that you get one deductible-free preventative-care visit per year.
How is that not a blank check to the medical industry ? I mean if this is true, it seems like it'd be trivial for the medical industry to exploit this loophole.
> How is that not a blank check to the medical industry ?
For one thing, because 100% coverage for medically-necessary care doesn't mean that everything that the provider would like to get paid for is medically necessary, and insurance companies are very enthusiastic (to say the least) about pursuing and denying and even clawing-back-payments-after-the-fact for unnecessary charges, even when they are only on the hook for some portion less than 100%; with 100% coverage, they are 100% motivated.
Then the Congress would make another law to fix it with more regulations. And another one to fix that one with even more regulations. That's how the system works. If you don't like it, elect different people to Congress.
The plans all have maximum annual out-of-pocket expense caps, above which you get 100% coverage, so it wouldn't be nearly as high as $60k. Checking the website, the out-of-pocket expense for the California Bronze plan is limited to $6,350/yr for an individual, or $12,700/yr for a family. This is precisely so that you can have a finite exposure that can be self-insured by keeping savings in an account.
So in your example, if you were on a family plan and hospitalized, you'd pay the first $5,000 entirely out of pocket (the Bronze-plan deductible). Then you'd pay 30% of the next ~$25,650 in expenses (~$7700), which would bring your out-of-pocket expenses for the year up to $12,700. At that point you've hit your out-of-pocket cap, so if there are still bills past $30,650, the plan would cover the entirety of the remainder.
The Bronze plan is essentially a high-deductible plan, but with the partial-coverage in between zone: you pay everything below $5,000, and nothing above $6,350/$12,700. The minor exception is that you get one deductible-free preventative-care visit per year.