Sure it does. The private insurance you bought through your HSA pays for that MI.
You can't use HSAs to pay your regular premiums.
More importantly, there is no magic to an HSA. All it does is give you a little bit of a tax break. It doesn't provide guaranteed issue, it doesn't ensure coverage for pre-existing conditions, it doesn't fix any portability issues, it doesn't bring down costs, and so on. That should be obvious by how HSAs
already exist and don't fix any of those problems.
The hospital is probably charging on average 50,000 for a MI.. with the cost of care probably averaging 23,000 or so. So the average reimbursement is probably 30,000 to 40000 range.
Nope. That's not how it works.
The hospital sets "Chargemaster rates" for procedures as a starting point for negotiations with the insurance companies, which knock it down by massive percentages. If you don't have insurance, the hospital will stick you with the entire bill. Sometimes you can negotiate it down yourself, but you have very little leverage, especially compared to an insurance company with tens of thousands of patients.
HSAs do nothing to change that dynamic.
I did not say that a HSA is in anyway a replacement for health insurance in the US. If you bother to read my post... the HSA is a vehicle so that employers can put money into the employees HSA so that employees … CAN BUY THE INSURANCE THAT WORKS FOR THEM.
Nope. That's not how it works.
Employers -- who, by the way,
do normally offer insurance with doctors on local plans, which is why most people like their employer-provided plan -- can get their workers onto insurance plans because they've got the numbers. Before the ACA, individuals trying to get coverage were utterly screwed. Premiums were high, deductibles were high, copays were high, coverage was weak, the insurers had entire departments dedicated to finding ways not to cover (typically on the basis of "pre-existing conditions").
That's if the insurer was willing to put you on their plans in the first place, which often wasn't the case. If you were over 40, a freelancer or unemployed, and trying to get health insurance? You were utterly SOL.
The advantage of the ACA is that it forces the insurers to take everyone, and stop the "pre-existing conditions" shenanigans. That only works when healthier ratepayers (usually younger people) pay for insurance. If you only get insurance when you're sick, the system doesn't work, because too many people will be able to freeload.
The ACA also makes it easy for independent individuals to figure out what plan works for them. It also requires coverage for preventative medicine. And since it offers guaranteed issue, it solves portability issues.
This, by the way, is why the ACA was fundamentally and originally a
conservative proposal, developed by the Heritage Foundation and implemented by Romney in MA. The mandate was the "Personal Responsibility Principle." The exchanges put insurers into direct competition. Medicaid expansion and subsidies were also part of the plan. Romneycare and the ACA are pretty much the only game in town if you want a private solution with the slightest chance of working. And of course, if Republicans had leaned into the ACA rather than constantly trying to kill it, it might have done as well as Romneycare did in MA.
So I guess you're just a closet ACA fan then, yes?