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Health Savings Accounts Under Attack

Health Savings Accounts (HSAs) are an oasis in the desert of government-run health care.  That is why President Obama’s health care bureaucrats are intent on killing HSAs.

According to a recent Wall Street Journal piece by 2021, health care spending will be almost one fifth of the whole U.S. economy.  In nine years, the government share will be about half.

By 2021, health-care spending is likely to be nearly a fifth of the U.S. economy, at 19.6% of gross domestic product, up from 17.9%, or roughly a sixth, in 2010. The government share of the spending also would be greater, at nearly 50%, up from 46%, mostly because of the anticipated growth in Medicare enrollment.

The government is projected to spend more on health care than the private sector.  That is a degree of socialism that is accelerating under ObamaCare and will cause the health care providers to be less responsive to consumers. 

HSAs are a force for good in health care markets and have been a positive element of the market since their creation in 2003.  An HSA is an account that individuals can set up to earn tax free health care funds on an annual basis.  They have been increasing in use since the day they were created. 

The idea behind these private accounts is to empower the consumer to make decisions on how to spend tax exempt dollars. Clearly, the last bastion of free market forces with the existence of HSAs is a threat to government run health care.  As a result, government bureaucrats are targeting HSAs for death.

HSAs provide quality medical coverage at the direction of the policyholder — not the government or insurance company bureaucrats.  That is why liberals hate them. 

HSAs provide power to the consumer to make health care choices.  People who have them, love them, because it empowers the consumer to make their own choices. 

It should not come as a surprise that the Department of Health and Human Services (HHS) is promulgating regulations that could rip 5 million policies out of the hands of small business plans and individuals.  Known as “Medical Loss Ratio,” these new regulations will make it nearly impossible for individuals or small businesses to use HSAs in the ObamaCare health exchanges.   

Many states will resist setting up ObamaCare exchanges for fear that the federal government will use these exchanges to control state based health care policy.  The battle over full repeal of ObamaCare will be fought into the fall elections, yet the bureaucrats in the Obama Administration will be working overtime to implement a law they hope will not be repealed by the voters this fall.

This crushing of free market HSAs is consistent with the liberal idea of creeping socialism.  They will not exterminate the free market in one day, or even one year, but over a long drawn out period of time.  The slow creep to socialism is difficult to stop, because it is incremental and done in small steps and by quiet bureaucrats who you will never hear about.

We all known that ObamaCare was built on a foundation of deceit but one promise made by the president was perfectly clear — he said that if you liked your plan and wanted to keep it — you could.  Add this to the long list of broken Obama promises.  Apparently Obama’s promise to allow you to keep your plan will not extend to HSAs should this new “Medical Loss Ratio” rule be implemented by Obama’s HHS Department.

Now that the Supreme Court has tossed another roadblock in the way of full repeal of ObamaCare, conservatives need to dig in and defend HSAs as one of the few remaining free market ideas left that provides consumers with the power over health care decisions. 

Many conservatives understand that ObamaCare was drafted in such a way as to deftly move people out of the private health market and into a government-run system.  Individuals and small business HSAs policyholders appear to be the first guinea pig in this experiment.

Congress needs to make sure to play defense on the free market and make sure that HSAs are not the next casualty of government centered health care.

COMMENTS

  • http://boldcolor.blogspot.com/ Paula

    A surprise behind every door. It’s like Mystery Date and the geek is behind every door.

    So now King Obama wants to take our HSA’s away from us so we can all be equal. Lovely.

    • jdbird

      I’m always amused by the looks I get when I ask how much something costs, usually followed up with a stammering reply of “I-I don’t know. . . . .um. . . d-do you not have insurance?” Then they go down the hall to ask someone in the back office who takes a few minutes to look it up. In a nut-shell what’s wrong with healthcare is that no one knows what anything costs and usually they don’t care.

  • jeffwtux

    Hi, I’m LibDem troll. I confess. There was no evidence or even any explanation for how ObamCare will threaten HSAs only the assertion that it will. However, I agree with enthusiastic support of HSAs. I LOVE LOVE LOVE THEM WITH ALL MY HEART. I feel all Americans should be ***ENTITLED***(favorite word by far, bash away) to be able to purchase a High-Deductible HSA plan from a ****FOR PROFIT****(I’m liberal CAPITALIST who owns stocks and loves when my companies ship jobs overseas and give me the dividends…I feel your pain Mittt) Insurer regardless of pre-existing conditions. Under current law people with pre-existing conditions CAN’T, and I know personally. I’m a 38 year old white guy: 6-0, 165lbs, and have a cholesterol level under 140. I was REJECTED for High-deductible HSA plans from 6 companies. One plan even had a $10,000 deductible:catastrophic enough for you? Under ObamaCare NOW I can sign up for a high-risk pool in Michigan which covers all conditions from DAY 1 with $1000, $2500, or $3500 deductible. No, there are no $10k deductibles here, but the later 2 are clearly high-deductible HSA plans, Current law doesn’t even allow for annual individual HSA contributions larger than $3050. That’s GWB policy. Under the Free-market exchanges of for-profit insurers, there will be similar deductible levels. How does that destroy HSAs?

    The GOP’s plan OTOH will dump high-risk people onto the TAXPAYERs on GOVERNMENT RUN SOCIALIZED high-risk pools. You think there are government death panels under ObamaCare? I guess there will be no oversight of those government run high risk pools that taxpayers are on the hook for. Conservatives will AND SHOULD ****DEMAND**** oversight boards….DEATH PANELS to reduce costs.

    No please explain to me again **with evidence** how ObamaCare destroys HSAs

    • jeffwtux

      Government run, and yes they will be government run or at least taxpayers will bear all the risk, high risk pools is to socialize all risk and privatize all profit. The ObamaCare free-market exchanges don’t. The for-profit companies must take the good with the bad insuring both low & high risk people.

    • The_Gadfly

      I FINALLY was offered an HSA by my employer two years ago. I’m older than you, shorter than you by a fair piece, and heavier than you by a good bit. I have reasonably priced “high” deductible that I can easily cover from the cash balance I put into the account each year.

      If you can’t purchase a decent HSA, it isn’t because private companies won’t offer them, it’s because the socialists you keep electing to govern your state have written your laws so restrictively they can’t offer them at a decent price.

      Oh, and no I’m not working for a Fortune 1000 company, I’m working for a small business with an owner who was looking to control his exploding healthcare costs. Couldn’t get it from the nearly lily white management at the socially conscious healthcare related beltway bandits I use to work for, but I can get from the company run by a recent immigrant (India I think, but it could be Pakistan where he’s from doesn’t actually matter to me, only that he has a good head for business. I’m just including these details to make your head explode).

      • jeffwtux

        not an individual policy. Sorry, I’m not lying., If you don’t believe me, I’ll post the letters. I don’t want my employer buying my insurance. I want him growing the business, creating jobs, and getting rich. If you don’t believe me, I’d be more than happy to post the rejection letters along with a doctor’s physical report.

        I know. The truth hurts.

        • mobius2702

          I don’t know what you could have done wrong, but getting an individual high deductible HSA policy in Michigan isn’t that tough.

          I left my employer mid April 2011 and by mid June 2011 I had the individual policy in place.

          Doctor’s physical report? Pah! Didn’t even ask for one.

          A couple of forms, a few phone calls to sort out some missing information, and like magic, the insurance cards showed up in the mail.

    • http://impudent.edublogs.org/ kyle8

      I thought you guys liked that. The reason risk pools and the many other reforms in a Republican plan are much much much better than obamacare is because obamacare is anti-market and instead of market forces pushing quality up and cost down you have the perverse incentives of adverse selection at work.

      Adverse selection means that a healthy person is better off just paying the tiny fine and then getting health care the moment they are sick or hurt. This will actually result in less people in the pool and thus higher costs. There are also numerous other bad, stupid things hidden in the law. As Nancy Pelosi said, we learn about more of them every day.

      • jeffwtux

        Heck, I’m for OUTLAWING ALL ABORTION & CONTRACEPTION PAID FOR BY INSURANCE. Frankly, both are SCAMS for the consumer. Obama was ok with ammending it too. Why do you think it’s 2700 pages? It’s to appease(I know that’s a terrible curse word. I apologize to all parents whose children who might read this) as many constituencies as possible, like the pro-life lobby. Antiabortion restrictions made up over 250pages in order to make every loophole airtight closed.

        Yeah, there is an aspect of socialism to all insurance, but if the profits are too be privatized, then the risk should be as well. If the risk is to be all socialized, nobody should be profiting off of that, just like how the RUTHLESS TERRORIST GOVERNMENTLABOR UNIONS(worst terrorists in human history, right?) profit from excess government spending and conservatives are outraged about it. Why is it any better when it’s a corporation? Either way, taxpayers are footing the bill and the person making the spending decision is corrupted by campaign contributions by the receiver of the spending.

        • http://impudent.edublogs.org/ kyle8

          I don’t like crony capitalism, but that is not what we are talking about. When you have a system in which the individual is subsidized by government but still has many options, then you have competition and you have a higher outcome.

          The Obamacare system is absent all of those market feedback mechanisms. Honestly this is why you people on the left can never understand how things really work and why reality always comes along and thumps you on the head.

          People on the right, and especially libertarian conservatives are not happy with corporations we understand all the abuses and things they will try to get away with. But we understand that big government is often much much worse.

          The more that you can privatize, decentralize, decision making, and the more power you can give individuals, it is almost always the better plan.

    • JSobieski

      The Medical Loss Ratio rule requires that insurance policies pay a certain percentage of dollars (80%, or 85% for employers with 50 or more employees).

      The problem is that the equation for the MLR will prohibit high deductible plans because the deductible counts against the 80%/85%.

      If you can’t find evidence that Obamacare threatens HSAs, your eyes are purposely closed.

      http://www.healthcarechoicecoalition.org/images/stories/pdf/mlr-regulation-creates-challenges-for-future-of-affordable-coverage-ramthun-white-paper.pdf

      http://www.hsacoalition.org/issue-analysis/the-new-medical-loss-ratio-rule-means-no-bronze-plans-in-obamacare/

      http://news.heartland.org/newspaper-article/2011/12/12/new-medical-loss-ratio-rule-means-no-hsas-obamacare-exchanges

      http://hl-isy.com/Healthcare-Reform-Blog/March-2012/Medical-Loss-Ratio-health-savings-accounts-030512

      http://obamacarewatcher.org/articles/347

      http://www.banyan-llc.com/bc/bc.nsf/archivedarticles/HSA-Enrollment-Continues-to-Rise

      http://healthblog.ncpa.org/new-regulation-threatens-agents-hsa-plans/

      • jeffwtux

        then the MLR goes up. I’m all for profit, but I’d rather see profits growing in industries that will grow the economy & create jobs. The USA simply isn’t growing organically the way we were 30-50 years ago. The only way we grow by selling more goods to countries who are growign organcally like China & India. We need to grow the pie, not just fight over how it’s divided. That’s accepted conservative thought and talking point. We need to support policies that benefit industries that sell overseas and grow the pie. There are few industries that control as much of the economy & sell as little overseas as for-profit health insurance. We get almost no growth from thier profit above an 85% MLR. We would get much more if small business owners or individuals got that money in the form of lower premiums.

        • JSobieski

          If you want to lower premiums–facilitate a real bona fide market in which individuals are empowered to shop and save.

          You can’t lower the premiums on an HSA to comply with the MLR because in most years you won’t even hit the annual deductible for the policy.

        • aesthete

          Um…. what?!

          As for the rest, what JSob said.

    • spandrel

      (Like you, I’m a capitalist, a 1%er to boot, but the rhetoric on the right and left are both so repellent that it’s a bit hard to take either seriously.)

      Regarding health care, I think it’s conceptually and morally in a singular category with education. For both health and education, a minimal universal coverage seems to be a sign and a prerequisite for a humane and productive capitalist society. There seems to be broad political agreement that we can mandate a personal investment in k-12 education, so I really don’t get the conceptual objection to something similar for health care.

      There’s a lot to dislike about the Affordable Care Act. For one, the federal government has no business solving this problem,, the states could do it much better. (Obama has said there will be more state waivers, sooner, which may or may not happen, though I think MA and HI already have theirs, which is kind of ironic.) But for all its flaws, it doesn’t need people making up ones that don’t exist, including this story about HSAs.

      The ACA specifically defines the minimal coverage (the “mandate”, without which one is taxed) to match an HSA + high deductible policy. States that do not offer such policies will have a great incentive to do so under the ACA.

      No doubt there will be unintended consequences regarding the price of such policies. There always are. But since consumers will be able to make head to head comparisons of such policies on exchanges, and since insurers will have to offer the same policy at the same price to all comers, it is likely that they will compete more on price.

      Personally, I expect my rates to go up. I have an HSA + an HD policy for my family, and it is very affordable (even with 5 kids) because we are healthy; once my insurer has to offer this same policy to all comers at the same price, my rates are unlikely to stay the same.

      • jeffwtux

        and this is where we are. They can craft solutions right now. Rick Perry brags about his state’s economy non-stop. GOPs have ruled that state for almos 20 years. Why haven’t they done anything? Instead they have they have basically ciminalized ALL malpractice lawsuits(ALL OF THEM, YESSSS) yet have the highest uninsured rate and fight all attempts to fix it. Why haven’t all of these Southern GOP states led the nation in solutions?

        • tnfriendofcoal101368

          and it would save the mods some time and effort…a true win/win.

        • spandrel

          who instituted universal coverage in MA. And he was able to do so only because the GOP White House gave him a waiver on Medicaid rules.

          There are plenty of very Dem states (California?) that could have tried something by now, only Vermont seems inclined to make the effort. Mostly they just talk the talk.

        • JSobieski

          Federal tax laws encourage insurance through employers rather than individuals because companies can write off the expense . . . and individuals cannot.

          Your comments are all fire and no light.

          Healthcare is a substantive issue requiring substantive discussion. You duck out of any specific point, and instead talk exclusively in cliches.

    • mdavt

      There is a small problem with your analysis (actually there are several problems, but lets focus on one). You are conflating ‘High Deductible’ and HSA. A ‘High Deductible’ plan is a PREREQUISITE for having an HSA under current law. Your statement ‘the later 2 are clearly high-deductible HSA plans’ is false. They may clearly be high-deductible plans, but that says NOTHING about whether they are linked to an HSA to help pay for those deductibles.
      Mr. Obama and his like-minded allies have always been opposed to HSA’s and high deductible plans because of the dissonance those concepts create with their ‘health care is a right’ rhetoric. If they have their way such plans will not be allowed to stand, even though it is clear they can help reduce health care spending.

    • jrqberry

      Effective Jan 1 of last year, you could no longer use HSA funds for over the counter pharmacy items. Before the “Patient Protection Act” was passed, you could use your own money to buy healthcare related items (asprin, cold medicine, etc.) Now, it is only applicable for items with a prescription.

      Someone please tell me, if the new healthcare laws are supposed to help me, how does taking something away that clearly benefits me accomplish that?

      The cynical answer is….once the HSA’s are eliminated, those funds that were once pre-tax will now be taxable…resulting in more income for the government.

    • jrqberry

      Effective Jan 1 of last year, you could no longer use HSA funds for over the counter pharmacy items. Before the “Patient Protection Act” was passed, you could use your own money to buy healthcare related items (asprin, cold medicine, etc.) Now, it is only applicable for items with a prescription.

      Someone please tell me, if the new healthcare laws are supposed to help me, how does taking something away that clearly benefits me accomplish that?

      The cynical answer is….once the HSA’s are eliminated, those funds that were once pre-tax will now be taxable…resulting in more income for the government.

  • jeffwtux

    “If you can?t purchase a decent HSA, it isn?t because private companies won?t offer them, it?s because the socialists you keep electing to govern your state have written your laws so restrictively they can?t offer them at a decent price.”

    What socialists? The socialists that wrote pre-ObamaCare individual insurance law that Mitt Romney & conservatives want to go back to? Under ObamaCare ***INDIVIDUALS*** will be able to purchase plans of at least 3 deductible levels(at least 2 of which will be high-deductible HSA plans) regardless of pre-existing conditions. Something that *****MOST INDIVIDUALS**** can’t do now. I’m sorry for you’re either ignorant or in denial.

    • funwithknives

      and did not work in a vacuum. Whatever he did was always going to be somewhat ‘tainted’ (as viewed therough a Conservative’s lens).
      Every Potential Veto would have been over-ridden, as S O P.

      …and why I’m at it , where did you discover what Mitt’s final, definitive plans are for Health Care. Link the sucker, as I am not alone in wanting to see it.
      You said they got one, so whip it out………

      Oh and I live in Michigan and there ARE Socialists here. but Jenny left so there are two fewer.{She and Dan The Man, of course}
      Others include The Dingell Twins John Conyers and Gretchen Whitmer. …and good old Virg Bernero.
      Yeah we got ‘em, and they’re no good at concealing it.

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