Tag: "Health Savings Accounts"

HSAs Under Attack

Three separate provisions in the statute, and regulations implementing the law, will reduce access to HSA plans:

  1. ObamaCare’s essential health benefits package contains new restrictions on deductibles and cost-sharing, which will prevent at least some current HSA plans from being offered.
  2. ObamaCare’s medical loss ratio regulations also impose new restrictions that studies show will hit HSA plans particularly hard, and could force individuals to change their current form of coverage.
  3. The ObamaCare statute does not specify that cash contributions made to an HSA will be counted towards the new federal actuarial value standards.  And a February bulletin released by HHS in advance of upcoming rulemaking indicates that under the Administration’s approach, not all contributions into an HSA will count towards the new minimum federal standards – meaning some HSA policies will not be considered “government-approved.”

More from Chris Jacobs on ObamaCare’s negative effect on health coverage.

May 15, 2012 | 6 comments | by

Shopping for Care

Castlight Health [is a] nascent health care start-up…with the goal of giving insurance subscribers meaningful information on health care costs. Castlight, in the simplest terms, wants to bring comparison shopping to health care.

It launched, last year, a Web site where employees on [Health Saving Account] plans can compare what doctors charge for the same service. The site…also includes other patients’ quality rankings of doctors, alongside information on what remains in an individual’s account.

More from Sarah Kliff at Ezra Klein’s blog.

May 02, 2012 | 2 comments | by

High Deductible Health Insurance

Question: If I asked you to point to the most obvious examples of wasteful health care spending, where would you direct me? This is a no brainer. There is nothing more wasteful than first-dollar health insurance coverage. Even deductibles as low as $1,000 or $1,500 are incredibly wasteful in many places. By that I mean that if you choose a higher deductible, the premium savings is greater than the additional expense you are exposed to. That means you can put some of the premium savings in the bank to cover the additional risk exposure (dollar-for-dollar) and still come out ahead.

Second question: When is the last time you saw an article in Health Affairs or any other health policy journal pointing out this obvious way to eliminate waste? My guess is that your answer is “never.” I’m sure you have seen articles about the hazards of high deductible insurance. Why are the journals so reluctant to focus on the benefits?

Every serious study that has ever been done on the subject has found that patients spend less on health care when they are spending their own money. The latest study by the RAND Corporation estimates that families with high deductible plans and Health Savings Accounts spend about 30% less than families with conventional insurance. And that’s with HSA plans designed by Congress. Think how much more effective the accounts could be if they were designed by the marketplace.

Further, no patient group was harmed by the switch to high-deductible insurance — not even vulnerable populations. This echoes the earlier findings of the RAND Health insurance experiment more than 30 years ago.

Ooh I’m driving my life away,
looking for a better way,
for me

Apr 09, 2012 | 47 comments | by

A Better Way to Slow Medicare

A report that will be released this week by the American Enterprise Institute finds that competitive bidding can save more money than the President’s budget proposals without endangering the care of millions of seniors. The authors—Roger Feldman of the University of Minnesota, Robert Coulam of Simmons College, and Bryan Dowd of the University of Minnesota—estimate that competitive bidding that includes all Medicare plans could save $339 billion over a decade. That is the approach taken by Sen. Ron Wyden (D-Ore.) and Rep. Paul Ryan (R-Wis.) in their bipartisan Medicare reform proposal.

Better yet, these savings reflect what health plans already say they can do. They are based on the actual bids of Medicare Advantage plans and the actual cost of traditional Medicare to provide full benefits without scrimping on health services.

Full article by Joseph Antos. AEI study here.

Feb 16, 2012 | 4 comments | by

BREAKING: Regulations Threaten HSAs

A new report by Milliman Inc. says that high-deductible health plans, including those with health savings accounts (HSAs), will likely be more adversely impacted by the medical loss ratio requirements under the Patient Protection and Affordable Care Act (PPACA) than other types of comprehensive medical plans.

“HSAs were widely anticipated to be the low-cost bronze plans for consumers under the Patient

Protection and Affordable Care Act,” said Kevin McKechnie, executive director of [the American Bankers Association] HSA Council. “The medical loss ratio requirements make this very difficult…”

Press release. Previous post on Roy Ramthun’s white paper.

Feb 14, 2012 | 6 comments | by

Kaiser Health News Explains HSAs

In an article ostensibly designed to answer frequently asked consumer questions about Health Savings Accounts (HSAs), Kaiser Health News has this to say:

  • “HSAs can be confusing.”
  • “HSAs have two basic elements: A tax-preferred savings account…and a high deductible health insurance plan…any adult with a high-deductible health plan and no other form of health care coverage can establish one of these accounts.”

[Translation: you probably don’t want one of these.]

In the rest of the article HSAs/high-deductible health plans are described as a way for employers to control costs, as problematic for low-income individuals, as having a straitjacket design, as requiring consumers to pay the full-dollar amount of their medical expenses until they meet their deductible, and as discouraging certain types of medical care.

Nov 14, 2011 | 6 comments | by

Three Cheers for Sen. Hatch

The Family and Retirement Health Investment Act of 2011 will:

  • Allow a husband and wife to make catch-up contributions to the same HSA;
  • Remove the onerous new restrictions on the use of HSA and FSA dollars for the purchase of over-the-counter drugs;
  • Allow individuals to roll-over up to $500 from their FSA accounts;
  • Clarify the use of prescription drugs as preventive care that will not be subject to an HSA-eligible plan deductible;
  • Reauthorize the use of Medicaid health opportunity accounts;
  • Promote wellness by expanding the definition of qualified medical expenses to encourage more exercise and better diet;
  • Allow seniors enrolled in Medicare Part A to continue contributing to their HSAs; and
  • Allow for the purchase of low-premium health insurance and long-term care insurance with HSA dollars.

Read full post on the Family and Retirement Health Investment Act of 2011.

Jun 07, 2011 | 5 comments | by

HSAs vs. HRAs: Which is Better?

I had a conference call this week with the commissioners of a county who are considering adopting Health Savings Accounts for their employees. They said their current broker has been discouraging them from doing so in favor of a Health Reimbursement Accounts instead. They wanted to pick the brain of someone who has no axe to grind.

I told them that HRAs are fine, but not as effective as HSAs in most situations. I explained that the American Academy of Actuaries (AAA) has long held that the economizing behaviors depend largely on to what extent employees view the money as their own. HSA funds clearly belong to the employee and to no one else. HRA funds are always the employer’s money and may be spent solely on services that are covered by the employer’s health plan.

May 19, 2011 | 11 comments | by

Only 51 Senate Votes Needed to Repeal ObamaCare, and Other News

Only 51 Senate votes are needed to repeal ObamaCare. Keith Hennessey: Democrats passed it with reconciliation; Republicans can repeal it the same way.

CBO: Obama care will cost 800,000 workers.

Fact-checking the Secretary. Sebelius responds to the states.

Between August 2009 and December 2010, the electronic health records of more than 6 million individuals were compromised. 61 percent of those security breaches were the result of malicious intent.

Health Savings Account paired with a wellness program.

Feb 14, 2011 | 7 comments | by

Is Big Pharma to Blame for the Restrictions to HSAs?

Was Big Pharma behind the new restrictions on HSAs and FSAs? What about the AMA?

Doctors are influenced by drug companies and that’s a good thing. Sally Satel review of White Coat, Black Hat.

What’s the best place for a medical home? Your own home.

Oct 27, 2010 | 7 comments | by
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