The Misuse and Abuse of HSAs are Hurting Consumers
By AAPS, Special for USABR.
When Health Savings Accounts (HSAs) were enacted, it was hoped that they would transform the medical marketplace and substantially lower prices because consumers would be spending their own money instead of a big insurance company’s money, states AAPS executive director Jane M. Orient, M.D. “But from the outset, they were hampered by regulations.”
Congress is finally considering a law, H.R. 365, that would allow the use of HSAs for this purpose. Unfortunately, a “few small changes” were made on the way to the House Committee on Ways and Means, which have greatly damaged it, states AAPS.
For example, people cannot use their HSA funds to pay their membership fees for a Direct Primary Care practice. Moreover, if they are members of a DPC practice, they may not even make a contribution to their HSA.
Congress is finally considering a law, H.R. 365, that would allow the use of HSAs for this purpose. Unfortunately, a “few small changes” were made on the way to the House Committee on Ways and Means, which have greatly damaged it, states AAPS.
Under the new language, DPC practices would have to comply with several federal requirements in order to become HSA-eligible. One provision limits the care provided under the agreement to specific procedure codes in the AMA’s Current Procedural Terminology (CPT) system, which is not conducive to facilitating free markets or advances in medical care. Another would prohibit DPC arrangements priced over a certain threshold from being HSA-eligible. Others further limit how the pricing can be structured and what care can and cannot be included.
If the bill passes in this form it would put practices that don’t comply with the federal rules at a competitive disadvantage to practices that align their model to satisfy government regulators instead of their patients.
In a letter to Chairman Kevin Brady (R-Tex.) and members of the House Committee on Ways and Means, AAPS writes: “HSAs are supposed to increase patient choice, not constrain it. Tax law should not be used to hand out advantages to special interests.”
“But from the outset, they (HSAs) were hampered by regulations.”
Particularly concerning are proposals that would discourage patients from seeking higher quality care from independent physicians or facilities instead of care at “retail clinics,” which are generally staffed by nonphysicians.
AAPS also objects to sneaking in changes at the last minute before markup so there is no opportunity for public input.