They think it's a game: greedy health insurers plan to keep premiums low by raising deductibles.

In America, health insurers -- members of an "industry" best defined with obscenities -- apparently think it's a game.

Yes, they think your health, your wellbeing, your finances, are a game -- a game of profiteering and rent-seeking with your wallet and your tax dollars.

From Investor's Business Daily, we learn insurers are keeping premiums low for 2016 Affordable Care Act (ACA) plans, while dramatically raising deductibles.

ObamaCare costs will jump next year for exchange customers, one way or the other. Premiums are set to spike by more than 20% in at least 16 states. But, for many, the real sticker shock will be soaring deductibles that mean they'll get few benefits until they've racked up huge bills.

Low-end bronze plans have deductibles hitting $6,850 in 2016. Now insurers are hiking silver-plan deductibles as high as $6,500 as a way to keep a lid on premiums. The downside isn't just more out-of-pocket costs for patients; it also will have a ripple effect of reducing taxpayer subsidies for cheaper plans.

Did you catch that last bit, my friends? This is bait and switch. Insurers win favor with the government by keeping the subsidies you get relatively flat, all the while increasing your out-of-pocket costs by imposing punishing deductibles.

Again, they think it's a game.

What follows is how the game will be played in Indiana -- by wealthy health insurance executives.

Customers who choose Ambetter's $6,500 deductible plan in Indianapolis will get limited benefits such as primary-care visits at a cost of $30, specialist visits for $60 and generic drugs for $15, along with free preventative care such as vaccines. But big-ticket items like diagnostic testing, MRIs, specialty drugs, emergency-room visits and surgical procedures aren't covered until after a patient racks up $6,500 in in-network bills.

The Ambetter plans also stand out in another way: By offering the two lowest-cost silver plans in the Indianapolis market with ultra-high deductibles, the insurer is driving down the subsidies available to purchase either more comprehensive coverage or lower-cost bronze coverage.

That's because the size of exchange subsidies depends on the price of the second-cheapest silver plan in each market. Largely because two Ambetter plans are priced so low, the subsidy available to 30-year-olds earning 250% of the poverty level in Indianapolis-area Marion County will fall from $1,140 this year to $809 in 2016.
That will hike after-subsidy premiums for the cheapest bronze plan by 25% to $1,914 a year.

This will also happen in Washington.

The same thing will happen in Seattle-area King County, where smaller subsidies and higher bronze premiums will boost the after-subsidy cost of the cheapest bronze plan by 21% to $2,112 a year — three times ObamaCare's minimum $695 individual-mandate tax penalty for going uncovered in 2016. Given that the cheapest bronze plan, also offered by Ambetter, has a $6,800 deductible, chances are high that young adults will pay the fine.

They think it's a game, but for patients this is a game with life and death consequences.

Huge deductibles force patients to delay care. And because patients are not doctors -- they don't know when it's safe to delay care or not -- patients risk their lives when they do so.

Gallup said that about 38 percent of middle class people with a household income of between $30,000 and $75,000 per year have delayed medical care because of costs, up from 33 percent last year.

Meanwhile, about 28 percent of households earning above $75,000 said they delayed care this year, compared to just 17 percent in 2013.

Indeed, the New York Times reported yesterday that many patients -- particularly in those states that refused to expand Medicaid -- are being forced to give up their ACA plans due to high costs.

What are they doing without health insurance? Yup, turning to God -- America's exceptional health care "system."

In the 20 states that have not expanded Medicaid, many people whose incomes are above the poverty level can qualify for subsidized private coverage. But like Ms. Douglas, who said she earned about $19,000 last year, many may struggle to pay for the coverage month after month even with substantial subsidies.

Ms. Douglas, who said she was unaware of the debate over expanding Medicaid, said she was returning to school and hoped to get a degree that would help her find full-time work. For now, she is taking aspirin instead of a prescription blood thinner to prevent another stroke and stretching the statins she takes to lower her cholesterol.

“My prayer is that God will show favor for my employment status to move from part time to full time,” she said. “I don’t want to keep trying to get something I can’t pay for.”

So, in a nutshell, we have the following: poor people -- and the middle class -- already can't afford all the costs associated with accessing health care in America, but instead of the problem getting better, wee have the following: insurers gaming the perverted system to keep premiums "low" by increasing deductibles, which will just mean a greater overall financial burden for American patients.

To be frank, if Canadians or Europeans were forced to adopt the ACA as it stands today, there would be riots in Toronto, London, Paris and Rome.

To be frank, the American health care "system" could not be more disastrous for the poor and middle class. It is literally the most regressive, pro-rich health care system in the entire developed world.

We must push forward and demand an end to this madness. We must revisit health care reform and demand single-payer, Medicare-for-all.

I know that Bernie Sanders wants to do this. He has my vote, because the status quo in health care, while a bit less barbaric and cruel than it was in 2013, remains an absolute nightmare for 99 percent of Americans.