Replacing the ACA: Will Health Savings Accounts Work?

Replacing the ACA: Will Health Savings Accounts Work?

The problems with high-deductible plans and health savings accounts

Note: I am beginning a series of posts examining various approaches the Republicans are touting as replacements for the ACA. Sorry, but no alternative facts here.

Several years ago (ie, pre-ACA), I needed to buy health insurance on the open market. The cost of an individual policy and the deductible was atmospheric because I had a pre-existing condition. And, of course, the policy didn’t cover costs related to my pre-existing condition.

Luckily, I had just incorporated my business. Since I had two employees (my husband and I) I could get a small business policy. Still expensive but manageable with decent coverage since employer-provided plans can’t discriminate based on pre-existing conditions.

I chose the cheapest plan, which came with a very high deductible. This plan also allowed me to create a health savings account (HSA). Money deposited into an HSA is not subject to federal taxes, grows tax-free, and is not taxed when used for qualified medical expenses (but not premiums).

What a Health Savings Account Can’t Do … Continue Reading

ACA Affordable Care Act health savings accounts healthcare costs healthcare reform high-deductible health plan politics

Yes, We Need Some Sanity–For the IRS!

The 14-year-old has homecoming (and a date) this weekend, otherwise we would be at the Jon Stewart Rally to Restore Sanity. If I were in Washington, however, I’d also have to wander over the IRS to try and restore a little sanity to the idio. . . um, hardworking government employees who work there. Seems the IRS recently issued its annual rules about what  the money in  medical savings accounts (those accounts created with pre-tax dollars) can be used for.

As The New York Times reported earlier this week, the IRS says you can spend those pre-tax dollars on items like dentures, pimple cream, and even replacing real grass with turf if your kid has severe allergies; but not breast pumps. Why? To quote the Times’ article: “breast-feeding does not have enough health benefits to qualify as a form of medical care.” Instead, the IRS views it as being a form of nutrition only.

When I read those words my first impulse was to hop in my car, drive to DC, find the IRS building, whip off my shirt and bra, hook up a breast pump to my boobs, and march on the IRS office, preferably with about 5,000 other … Continue Reading

breastfeeding health savings accounts IRS