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 Home > Opinion > Story

Published - Thursday, August 21, 2008

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GUEST VIEW: Give HSAs a chance to work

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Here in Wisconsin, more than 210,000 people who are trying to save money on healthcare could get slapped with new paperwork requirements from Congress. These residents have health insurance that allows them to open a health savings account, a new type of investment vehicle that lets them put money aside for health expenses.

Created in 2004, HSAs are a proven way to make insurance more affordable.

Unfortunately, some federal lawmakers seem opposed to any free-market health reform. So they’re trying to undermine HSAs. It would be a travesty if these lawmakers succeeded.

To qualify for an HSA, individuals or families purchase health insurance with a high deductible — this is typically less expensive than a traditional policy. Then, they can put their savings into an HSA, similar to a 401K account that’s free of federal and most state taxes. The money stays with them from job to job and rolls over from year to year.

Users pay more of their medical bills up front, but in return, they enjoy lower premiums and more control over where their money goes.

In the past four years, HSAs have become enormously popular. According to a recent survey, more than 6 million Americans now have HSA-compatible insurance plans. Best of all, 1.6 million Americans have left the ranks of the uninsured thanks to HSAs.

Despite all this, there’s a push in Congress to make HSAs less appealing.

Withdrawals from the HSA must be spent on medical expenses, such as doctors’ visits, lab tests, and some prescription drugs.

Under a measure recently passed in the House, federal regulators would need proof that each withdrawal from an HSA is spent on qualified medical expenses. The bill is now awaiting approval in the Senate.

Substantiating expenses would be a costly and time-consuming process. And, undoubtedly, HSA providers would simply pass these new administrative expenses along to account holders. Experts estimate that the requirement could double the monthly account fees charged to HSA users.

Such a measure would also slow down healthcare transactions. Before you could withdraw $50 for your doctor’s visit, you might first need to prove to your bank where the money is going. And before your bank could let you have the money, it might have to prove to the feds that the money is for a qualified medical expense.

That’s a recipe for frustration since bureaucrats aren’t known for their efficiency.

The ostensible reason for this law is that HSAs are prone to abuse. And while there’s a risk that people will lie about where their money goes, there’s also a risk people will cheat on their taxes.

Luckily, there are safeguards in place.

Most HSA payments are made with a specially designated debit card, so it’s easy to track where the money goes.

And, according to the Government Accountability Office, at least 90 percent of HSA withdrawals last year went toward qualified medical expenses.

So what’s really driving the anti-HSA crusade? Politics. Opponents claim that HSAs are a tax shelter for the rich and are attractive only to the young and healthy.

But according to America’s Health Insurance Plans, a national association representing more than 1,300 insurance providers, the fastest growing constituency for HSAs is the small-group market, comprised mostly of small businesses. HSAs are an invaluable tool for employers looking to avoid rising health costs. And they’ve helped provide low- and middle-income Americans with more affordable health insurance options.

Lawmakers shouldn’t be throwing up administrative hurdles to keep Americans away from HSAs. Let’s hope petty politics doesn’t trump sound policy in the Senate.

Grace-Marie Turner is president of the Galen Institute.
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Peggy wrote on Aug 25, 2008 12:43 PM:

" I agree that HSA's have a lot of potential and Congress shouldn't make them harder to use. However, I recently learned they are far from a safe haven. Here's my story:

My husband and I are self-employed small business owners living in Pennsylvania. We have had a high deductible HSA (was originally a MSA [medical savings account plan]....then converted to an HSA when Congress passed new legislation) with Assurant Health since March of 2000.

When we started with 2 children and 2 adults covered, the quarterly premium was $892 and the calendar year family deductible was $4,500; total out of pocket in or out of network was $5,500.

By last September (2007), our quarterly premiums had increased to $2,615 with the same deductible. An increase of nearly 300% in seven years.

This June we received a letter informing us that Assurant Health was discontinuing our policy and replacing it with one of their new products. When we received the details of the new policy three weeks ago, we learned that the quarterly premium (now for 2 adults and 1 dependent) will be $3022.32 ($12,088/year) and the deductible will increase to $5,700; maximum out-of-pocket in-network will be $10,700; out-of-pocket out-of-network will be $18,700. AND even though we have met our $5,500 deductible for 2008, as of 9/1/08, Assurant says there will be another $1,200 due from us before they will cover anything further - and then they will only cover 50% of the next in-network $10,000 in medical expenses.

Three years into the policy, my son had a sports injury and my husband was diagnosed with cancer which caused us to meet our deductible for seven years in a row - starting in December 2002 through June 2008. This has meant that we were never able to build up funds in our HSA as a hedge against future medical expenses as our deposits were almost immediately withdrawn to pay for current medical costs.

Assurant Health paid the claims throughout this horrible period. And I am extremely grateful to have had the coverage during that time. But now by dropping our policy and issuing a new one priced as it is, it is impossible for us to afford continuing the coverage. And even though my husband has been cancer-free for over five years, no other insurance company is interested due to his health history. "


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