Why are marketplace Bronze & Silver plans cheaper overall when reaching out-of-pocket max? Shouldn’t Gold be cheaper overall for high healthcare usage? (Spreadsheet screenshot included!)

I put every 2024 healthcare.gov marketplace plan in an Excel spreadsheet (screenshot here) with its premiums (minus $491/mo premium tax subsidies due to our income), individual deductible, and individual out-of-pocket max.

My wife will be delivering a baby in 2024, and we want to choose the best plan. From other threads on this subreddit, I am led to believe that we can expect to reach the out-of-pocket max for a normal pregnancy and delivery. As such, all that matters is which plan's 12 months of premiums plus out-of-pocket max is the lowest number.

As you can see, and much to my surprise, the bronze and silver plans win out. The gold plans range from mediocre to laughably expensive. What is going on here? Isn't the whole point of Gold plans that you pay higher premiums in exchange for lower costs in the event you incur a lot of healthcare expenses? Obviously these plans will differ in terms of cost sharing after the deductible is reached, but that shouldn't matter for our purposes because the out-of-pocket max is what it is regardless of what sort of cost sharing got you there.

Or am I wrong to assume that one should expect to reach ~$10,000 out-of-pocket costs during a year with a childbirth in it? That really did seem to be the consensus across past threads when I sought out opinions, but perhaps they had in mind employer plans with much lower out-of-pocket maximums? I don't know.

What am I missing?

Thanks in advance!

submitted by /u/HelmedHorror
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