This sort of still works? (story time!) I mean, my place of employment offers different levels that deduct different amounts from my paycheck which is matched (I think) by the employer. So, for me, I am in good health so I am enrolled in the basic tier. My deductible is higher because I do not have a recurring issue and don't have as many office visits. However, I do have an out of pocket maximum and a small pool of money for routine visits/the cold/etc. With that sort of program, my deduction every two weeks is lower than someone in the higher tiers. Now, if you were to ask me where the state/federal funding to my program starts and stops, I could not tell you. I am also not sure how the ACA plays into it since I got this position after it was implemented, so I have nothing to compare it to.How about a huge amount of fat.
I was thinking (yeah I know it hurts my head) but when I was working for Sun Microsystems the company had a very basic health plan that they paid for (can't remember the details it was over 20 years ago). The employees could purchase additional coverage (again can't remember the details) to what ever they thought they needed. I can't see why this type of plan couldn't work. Except that the federal government would not pay for the basic plan unless except in "hardship" cases and the individual could pay additional for any expanded coverage.