Utilize your financial knowledge, give your answer or opinion to the input question or subject . Answer format is not limited.

Who could afford a higher annual deductible who couldn't afford a higher monthly payment?
I edited in the total annual out of pocket for each level to help illustrate what's going on. Your question makes sense, of course, but it's less a matter of afford vs an attempt to save. The way these plans work is to allow some choice based on your past experience. I can afford any option, but knowing the number of visits we have had in the past, the lowest cost option has the highest premium. A young couple who hardly sees a doctor may choose the highest deductible, risking the potential $3434 extra they may pay in a bad year for the savings of $1016.  Personally, I'd not be able to guess accurately enough to benefit from the middle choices, and can see the two extremes being picked most often.