Medium household income is about $57,000. The SUV guy has the option to use these plans. The guy making $57,000 doesn't. You can be judgemental about buying a SUV since he has a choice. The family on $57,000 doesn't have a choice.

The benefits of these plans are skewed to wealthier household. The benefits mostly go to the guy at the 40% tax rather than one at the 10% rate.