Wednesday, May 17, 2017

Missed it by *THAT* much

As regular readers know, I'm a big fan of Health Savings Accounts (HSA's). And of course I'm far from alone; in fact, uber-wonk Michael Cannon (among others) has been proposing expanding their availability as a (partial?) cure for ObamaCare. Unfortunately, these plans may best be characterized as "necessary, but insufficient."


Here's an example from the Dallas News, from a recent article titled "This little health care funding mechanism could solve our big crisis." In it, Kevin Simmons (an economics professor at Austin College) walks us through the political processes that have brought us to where we sit now, and then segues to how HSA's could help:

"One provision could create common ground: health saving accounts. The idea is simple; you deposit money tax-free into an account and that money is available for medical expenses ... use of HSAs could be opened up to people on all insurance plans, not just those with high deductibles."


First, Kevin, I applaud your willingness to explore new economic models, and am glad to have you aboard the "HSA wagon." But (and you just knew there'd be a "but"): nowhere in that 700+ word article do we see the term "catastrophic." Now, why is that important? Well, the premise of HSA's is that one has enough cash left over after having paid one's insurance premium (or not; more on that in a moment) to actually have shekels enough to contribute to the account. As long as we have to pay for birth control and maternity (and all the other EHB nonsense, let alone pre-ex coverage and no underwriting), very few people are actually in this boat. So you're proposing to expand something most folks can't afford in the first place.

(By the by, why not allow DPC subscription fees to be HSA-eligible?)

And riddle me this: why does the HSA have to be tied to owning any insurance plan? What if I'd like to completely self-insure? No one seems to be asking (let alone answering) that one.

If I sound frustrated, it's because I am: I would really like to see either full repeal or, failing that, some kind of carve-out for truly catastrophic plans exempt from EHB's, etc. Such would be an acceptable start, anyway.

Okay, rant over.

(For now)
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