Tag: "HSA"

Major Breakthrough; Timid Step Forward

This is something the Bush Administration never was willing to even consider

The Obama administration loosened rules governing health-care savings accounts known as flexible-spending arrangements, or FSAs, allowing consumers to roll over as much as $500 in unused funds each year. (WSJ)

health-savings-account-bankThis means the accounts will partially function just like Health Saving Accounts. Employers potentially will be able to put up to $500 in an account for every employee and let that integrate with an overall health plan with none of the restrictions that hamper HSAs.

This is 35 million people, in addition to the 30 or so million that already have an HSA or HRA.

But why only $500? Why not the full amount? $2,500 is the new allowable contribution.

What Large Employers Are Doing

They’re sending their employees to private exchanges, armed with HSAs and HRAs:

Employers are raising deductibles, giving workers health savings accounts that look like 401(k) plans, mimicking the health law’s online insurance marketplaces and nudging patients to compare prices and shop around for treatments. Together the moves could eventually affect far more consumers than the law’s Medicaid expansion or health exchanges aimed at the uninsured and scheduled to open Oct. 1. (Kaiser Health News)

See Walgreen and others.

15.5 Million People Have a Health Savings Account

growthhsa

Source: AHIP.

What Works Better: Bureaucracy or Markets?

Aaron Carroll and Austin Frakt relate the problem:

Over the past decade, the number of reimbursed eyelid-lift procedures has tripled. The cost to taxpayers has quadrupled, to $80 million from $20 million.

Medicare traditionally avoids coverage for cosmetic procedures such as Botox or breast augmentation (except after medically necessary breast removal). So why cover eyelid lifts? It’s possible that more of the elderly are suffering real vision problems in need of corrective surgery.

But is it likely that a disproportionate number of these patients live in one state? More than half of the 20 highest-billing physicians were in Florida, where one doctor submitted for 2,200 eyelid lifts in 2008 alone.

Their solution: better Medicare oversight.

My solution: Get Medicare completely out of the business of eyelid lifts. Let patients pay for all such procedures from their Health Savings Accounts.

Liberating Health Savings Accounts

Senators Orrin Hatch (R-UT) and Marco Rubio (R-FL) have introduced legislation to eliminate many of the restrictions currently placed on HSAs and FSAs. For instance, the bill would allow HSA accounts to be used to pay health insurance premiums. The bill allows eligible spouses 55 and older to make HSA catch-up contributions to the same HSA account and it allows Medicare beneficiaries to contribute to HSAs after age 65. Also, Medicare beneficiaries in an MSA plan will be able to contribute their own tax-deductible money to their MSAs.

Ramthun on HSAs for the Military, and Other Links

Roy Ramthun asks: why can’t the military and their families have Health Savings Accounts?

P4P in Australia: Physician behavior didn’t change.

Can you cure yourself by just thinking?

Britain doesn’t prove the Keynesians are right; it proves they are wrong.

Headlines I Wish I Hadn’t Seen

Tax-exempt hospitals spend an average of 7.5% of their operating expenses on community benefits.

First the “doc fix”; now a hospital fix.

Will regulations make HSA plans unattractive under ObamaCare?

Austin Frakt and I Agree on Something

Across-the-board deductibles don’t make a lot of sense. In Priceless, I argued that whole categories of care should be transferred to the patient in some cases and there should be first-dollar coverage for other kinds of services. Austin Frakt seems to agree, reproducing this graph from the book, and remarking:

LASIK is an elective procedure, the purpose of which is well understood by the patient. I’m on board with the idea that insurance shouldn’t cover such things, or if it does, not the full cost and certainly not the marginal cost. All health procedures just like this are good candidates for the purview of John Goodman’s “New HSA.”

New HSA

The issue is not whether the procedure is like LASIK surgery, however. The issue is whether choices by the individual will create costs for other members of the insurance pool. Where there are no “financial externalities,” the case for individual decision-making is strong.

Austin Frakt Endorses Health Savings Accounts, and Other Links

Austin Frakt endorses health savings accounts.

You can’t be CEO if you’re fat.

There is no nursing shortage.

There is no doctor shortage.

High Deductibles are More Common

The growing prevalence and amount of deductibles has resulted in an increasing percentage of covered workers enrolled in a plan with high deductibles. In 2012, about a third (34%) of covered workers were enrolled in a plan with a deductible of a $1,000 or more compared to 10% in 2006, and 14% were enrolled in a plan with a deductible of $2,000 or more compared to 3% in 2006. The percentages of workers include workers who are enrolled in a high deductible plans with a savings account (HDHP/SO), such as an HSA or an HRA, and those who are in a plan without a savings account.

Source: Kaiser Health News.