Obama needs to make HSAs available to EVERYONE

[TwixVoy]

Right now I am lucky to say I have relatively decent health insurance. Premium costs me $30/pay check. $2000 deductable on an 80/20 percent system, and after that coverage is 100% with no limit for the year.

However, with the way benefits get cut more and more each year it is only a matter of time until that decent insurance goes out the window and is replaced with some extremely high deductable crap insurance with limited coverage.

Right now I can't contribute to a health savings account (HSA) because I have relatively decent insurance and by law am not allowed to. I think the law needs to be changed so that EVERYONE can contribute to an HSA regardless of if they have good insurance or not.... because you never know when that good insurance is going to go out the door.

[sandnsea]

1. I want health care

HSA's promote sickness, not wellness. People do not use them for prevention, which makes health care more expensive in the long run. They're stupid. And so is a $2,000 deductible and a 20% co-pay because if you can barely afford to make your premium as it is, you can't go see the doctor anyway because you can't afford to pay $200 a visit plus your premium.

[TwixVoy]

2. Exactly

I would NEVER advocate an HSA being the primary vehicle for paying for medical care. However, you are right with a $2000 max out of pocket you may NOT be able to pay all of that at once.

Which is why I feel HSAs should be available to EVERYONE. So, for example, I could put away $100 a month in to the HSA. In two years I would have over $2000 in the HSA. So let's say three years from now I get in a major car accident and suddenly owe $2000. Instead of having to panic and wonder where the hell I am getting $2000 all at once from I can just use my HSA.

[shraby]

26. Many times the HSA cannot be carried into

the next year. It has to be used in the current year or it's gone.

[TwixVoy]

30. You are thinking of an FSA

My god can this many people here really not know what an HSA is and how it can be useful? FSA (Flexible spending accounts) can't be used from year to year. An HSA is a savings account for health expenses that is YOUR MONEY ALWAYS. It will never NOT be yours or go away if you don't use it.

[Book Lover]

59. Thank you for that explaination

becaue I assumed you were talking about the "we take your money away" accounts also. But I don't understand the difference between an HSA and a savings account I myself set up.

[TwixVoy]

62. I'll explain

Let's say you walk in to Chase bank tomorrow. You open a regular savings account and put $500 in it. You expect to use that $500 over this next year to pay for over the counter meds, bandages, your prescription co-pays, etc. Guess what? You are paying federal income tax on that $500 this year. Basically you used $500 for medical expenses, but you are getting taxed on it. Why the hell should you pay federal taxes on money you used for your medical care?

So let's say tomorrow you walk in to Chase and open a health savings account and put in that same $500. Let's say over this next year you make the SAME exact purchases you would have made for those medical items as you would have out of your regular savings account. Guess what? Because you used the money you put in your health savings account to pay for those items you owe NOTHING in federal income tax for those expenses.

Right now the system is set up to screw you. Right now in order to open a health savings account and use it the same way I describe above you HAVE to have shitty insurance that costs you out the ass. If you have insurance that does NOT cost you out the ass you legally can NOT open that account. What I would like to see happen is make it so ANYONE can walk in to Chase bank tomorrow, open a health savings account, and use the money from it TAX FREE for ANY MEDICAL EXPENSE.

Apparently half the people on this thread though believe that giving people the ability to buy medicial items TAX FREE is a horrible thing to do though.

[sandnsea]

108. Except people will choose to NOT see the doctor

when they should, which is the problem we already have. People waiting until they are really sick is why costs are so high. HSA's are not a good alternative to real health care.

[Fovea]

3. Right now we are entering a depression

I predict historically low savings and low employment.

Beyond you, and a handful of your still fully employed co workers,
you propose nothing in the face of disaster.

The system is broken, and a band aid to fix it for the already well insured is a sucky use of resourses.

[TwixVoy]

6. Bullshit

I propose nothing? Half the reason we are in this financial mess is due to the fact the country as a whole has a negative savings rate and is living on credit that can no longer be handled.

I think opening up more ways for people to SAVE and encouraging SAVINGS rather than SPENDING on cheap plastic toys at wal-mart is a much better way to fix this broken system than your desire to keep this runaway train going for another day so you can continue to acquire more cheap plastic items as the media tells you to.

[Donnachaidh]

13. you can't save what you don't HAVE. n/t

[TwixVoy]

14. Wake up to the fact bush is gone

We are going to have a time of growth and HOPE again in this nation once Obama takes office. You WILL HAVE it. What you need to do now is start trying to SAVE. Do NOT continue to feed the system by spending every dime you have so when you need it you don't have it.

[mmonk]

41. It is difficult. You have to keep making deposits to the account

to pay the deductable. The only upside is it is fully tax deductable.

[leftstreet]

33. If I dropped my internet service for 1 year, it wouldn't pay for a dental crown

Get a clue

Stop blaming the people

[geardaddy]

4. I say "boo" to HSAs

"Booooo"

:thumbsdown:

[KoKo]

100. Yes! Young employees put more in their accounts than they use...

My Nephew and friends daughter lost, respectively $500 and $300.00 in one year because their "Human Resources Advisor told them they needed to put a lot into their accounts in case of a disaster. Both are in their early to late 20's with no bad health reports and parents who are not ill with anything.

At the end of the year...neither had colds, flu or any other med problem so they didn't need to see a doctor..and they LOST their Health Account balances because they "over saved" into them. That's not saying that a Med Emergency wouldn't have eaten up their balance if they had a bad year...but then REAL health insurance used to take care of Med Emergencies in the past where one didn't have to put stuff into an account (just in case) and then "lose it, if they didn't use it." It was a scam and neither make alot of money so this was money they could have used against rent or for food and they lost it.

It's a SCAM...

[Lydia Leftcoast]

110. I do too

The premiums cost MORE per month than a comparable conventional plan, and then you're supposed to put $200 a month away BESIDES?

You know what an HSA REALLY is? It's a high-deductible plan in which you prepay your deductible. That's all.

[derby378]

5. HSAs? No thanks...

Insurances needs to exercise less control over healthcare, not more.

[TwixVoy]

8. Please do your homework

an HSA is a SAVINGS ACCOUNT not freaking health insurance coverage.

[Donnachaidh]

9. that is used to cover medical expenses covered by INSURANCE.

Thanks, but no thanks. It only serves to feed the insurance companies.

[TwixVoy]

15. No it doesn't

it covers your ass so you have funds available to help pay for the medical care you need. Or when you need a life saving medicine are you happy to not be able to afford it just to make a point?

[ourbluenation]

32. Yes it does sometimes. They are often tied into a health plan...

not always, but more than often they are. I have one.

[TwixVoy]

34. FSAs are also linked to health plans

However you will NEVER EVER lose your money in your HSA if you don't use it BY LAW. You have an FSA obviously and are confusing it with an HSA.

[ourbluenation]

118. It's an HSA held at the HSA bank. n/t

[derby378]

11. Who is going to administer that HSA?

The government? Some private corporation that doesn't have your best interest at heart?

We're starting to deal with too many variables in healthcare. Simplify, simplify, simplify.

[TwixVoy]

19. The same people who administer it now

For example, your credit union. My credit union offers HSA accounts. I do NOT believe the credit union is out to screw me. So why shouldn't I be able to save money in an HSA at my credit union?

[ourbluenation]

29. I administer HSA's and they are savings accounts tied to a health plan.

It's a high deductible health insurance plan. You first build up the savings with monthly contributions to cover the deductible, after that's met the rest is saved for medical coverage not covered by the plan or othe rmedical incidentals, like band aids or tylenal. If you're healthy and end up not accessing it it's a nice way to build a savings. If you have a lot of health problems then run in the opposite direction. I won't be useful to you.

[Donnachaidh]

7. forget HSA -- we want HEALTHCARE - single payer

It's pretty damned hard to contribute to an HSA when you're unemployed.

[Desertrose]

10. If we had universal health care, we wouldn't need HSA's

We can bailout Wall Street but we can't give medical coverage to our own citizens?

Bullshit.

[ColbertWatcher]

12. HSA's put healthcare money into the stock market.

They're not good.

[RB TexLa]

18. If you chose to invest your money in the stock market, there are many options

[ColbertWatcher]

22. You don't think the people taking in the HSA funds will be honest abot where it all goes?

HSAs will make it easy to throw money into the stock market.

They're no good.

[RB TexLa]

24. You chose where the money in your account is invested, not the administrator

[ColbertWatcher]

25. Like a 401k? n/t

[RB TexLa]

28. yes like a retirement account

[ColbertWatcher]

107. Which is why it's not a good idea.

http://www.investmentnews.com/apps/pbcs.dll/article?AID=/20081102/REG/311039985/1009/TOC

[RB TexLa]

113. Because one of the investment choices (stocks) have periods of negative growth?

That's a silly reason. HSA's just as IRAs 401(k)s and 403 (b)s have different investment options. If stocks are going down bonds are usually up if all else scares the participant there is a money market fund.

That's like saying driving is a bad option for transportation because some accidents kill people. There are things you can do to prevent accidents.

[ColbertWatcher]

119. Bad analogy.

Nothing in the market is safe, even T-bills are taking a hit.

[librechik]

16. I don't know about you, but there's no way I could save up for, say heart surgery

out of my $35,000 salary.

No one could. We need to pool our resources, share the costs, and get some tough cost cutters to run the administrative aspects.

PROFIT HAS NO PLACE IN HEALTH CARE!!! PERIOD!!!

Now, how to pry off all the leeches who have been making billions off BS healthcare decisions since the 70s. Never saw a leech who would let go once they have a good grip.

[TwixVoy]

20. An HSA is not for that

it's to cover the smaller expense BEFORE your insurance kicks in. Your deductables, or to pay for your prescriptions for example.

[tpsbmam]

43. And just how does that help the millions who can't afford the insurance that's

supposed to kick in or who are unable to get insurance at any cost because they have preexisting conditions?

You're not getting what people here are saying -- people are struggling to pay their mortgages and feed their families. If you look at retail figures, people are doing less shopping for crap and more saving if that's at all possible but mostly more scraping to pay the basics.

I'm with the majority here -- screw HSAs. Universal single payer health insurance would obviate the need for HSAs and for all of the other bogus crap necessitated by allowing insurance companies to dictate American health care.

[TwixVoy]

46. Really?

Single payer will pay 100% the cost of your prescriptions? Over the counter meds? Band aids? Rubbing alcohol? Hydrogren peroxide? These are the things an HSA can help you pay for.

[tpsbmam]

64. Do you do the shopping at home? Just curious.....

do you have any idea what hydrogen peroxide costs? An 8 oz. bottle is under $1. A 16 oz bottle of rubbing alcohol is about $1 to $1.50. I just bought a bottle of 400 aspirin that'll expire in two years -- cost me $9.73 or $4.87 a year. My bottle of 300 enteric aspirin cost me about the same IIRC -- that'll last me almost a year. I have multiple chronic conditions -- chronic kidney disease, multiple sclerosis, and about 3 more. I regularly take 11 prescription drugs and I take a number of vitamins. I'd say I probably take about the average number of OTC drugs, maybe less than average when it comes to "drugs," but more when it comes to vitamins. I could cut out some of the vitamins I just choose not to. With the vitamins, my OTC drugs probably cost me about $300/year. If I cut most of the vitamins out, it'd be about $30/year. PLease do tell me again why I need an HSA for the kinds of things you listed.

(Ed to delete an errant word.)

[TwixVoy]

68. Because it saves you money

ALL those items you listed YOU ARE PAYING THE FEDERAL GOVERNMENT TAXES ON. If you used that money out of a health savings account you would NOT be paying federal income tax on those items. Sure if you pay $100 a year the tax benefit won't be that huge, but it is something isn't it?

And news flash - just because YOU don't have many medical expenses doesn't mean other people don't. There are some people who pay OUT OF POCKET hundreds or even thousands of dollars a year in medical products over the counter. For them the tax savings could be huge. Why do you think people should have to pay taxes on items used for medical care?

[tpsbmam]

93. I don't have many medical expenses? HA! With 5 chronic conditions I don't

have medical expenses. Okay then!

[Hong Kong Cavalier]

17. No. Just...no.

I have an HSA.

It's my only available option through my employer. It's crap.
Even with my HSA, my insurance has turned to crap.

Just no.

[RB TexLa]

21. Happy to be the first rec for you.

[The_Casual_Observer]

23. How much would you have to save up for your average surgery?

Might as well try save up for a Ferrari.

[TwixVoy]

31. For the love of god

Once again an HSA is NOT supposed to be used to pay the core costs of health care. It is a SAVINGS ACCOUNT to help pay for deductables and prescriptions.

[The_Casual_Observer]

38. If you can't pay those (frequently ongoing) expenses out of

pocket, how do you suppose that anybody could save money for them?

[TwixVoy]

51. Jesus christ

Because using the HSA SAVES YOU MONEY. DO YOU KNOW WHAT AN HSA EVEN IS?

Let's say I open an HSA account at Bank of America. Any money I pull out of that account to buy ANYTHING for medical use - such a freaking bottle of aspirin even - is NO LONGER INCLUDED IN INCOME TAX. It SAVES YOU MONEY that is why it's useful to have.

WHY should people have to pay taxes on money they are using for medical care? WHY are you so opposed to that and think it's so horrible? When you open and use an HSA account at a bank you no longer have to pay federal income tax on the money you are using to buy things for medical care. Why do you feel a freaking bank savings account that eliminates the income tax on medical items is so bad?

[The_Casual_Observer]

112. Do you suppose that people who need this pay enough income tax

to have the tax break make any possible difference? Jesus Christ.

If you think that they would set up a plan like this without some horrible offset to the current & already less than adequate system you are nuts.

[ikojo]

27. HSA's are not the solution to what ails the health

care industry in the US....just look at this 2005 post from DUer Dr Ron.....

http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=132x1735238

From Light Up The Darkness--see original post for links:

http://www.lightupthedarkness.org/blog/?view=plink&id=7...

Health Savings Accounts Fail To Improve Health Care
20 April 2005


Health Savings Accounts have become the major Republican proposal for changing health care as they attempt to eliminate the system of employer-paid health coverage while being unwilling to consider increased governmental involvement as occurs in most of the developed world. Their real goal is to relieve supporters in business of their current health care expenses.

John Kerry was actually sympathetic to the problems faced by businesses, and aware of how this reduces American competitiveness. While Kerry's health care plan sought to reduce the burdens faced by businesses while expanding health care coverage, Republican proposals are directed purely at saving money for businessmen.

Previously Republicans attempted to reduce health care costs for business by encouraging movement towards HMO's, which were changed from a method of providing health care to a scheme to allow businesses to pay less on health care. As this HMO model has been found to be both economical inefficient and to be a poor method of delivering quality care (especially in the Medicare population, where Republicans continue to push for HMO's), Republicans were forced to go back to the drawing board and develop the HSA idea.

The Commonwealth Fund has published a review of the Republican proposal for Health Savings Accounts, finding that they provide little benefit for the uninsured, who will not receive sufficient tax benefits to make health care affordable, and are likely to exacerbate current problems as they "undermine the entire structure of job-based coverage among small firms."

We looked at earlier studies of problems with HSA's in January, showing the likelihood that this will lead to people avoiding payment for routine and preventative care out of reluctance towards paying out of their own funds. This results in long term increases in health care expenses. It is far less expensive to treat diabetes, hypertension, and hyperlipidemia early than to pay for bypass surgery, dialysis, and long term care following strokes. Similarly it is preferable, and less expensive, to screen for cancer than to pay for expensive treatments.

[mmonk]

35. I have an HSA. $720 a month premiums with a deductable of $5240.00.

[TwixVoy]

36. I simply can not believe how many people don't understand what an HSA is

What you have is a high deductable health insurance plan. The HSA is offered along side it as a way to help you pay for the high deductable. The HSA is NOT your insurance provider, nor is it your coverage. Your coverage is COMPLETELY seperate. The HSA is a SAVINGS ACCOUNT for you to draw from on the side nothing more.

[mmonk]

40. The savings account is what pays the deductable.

I have an HSA.

[madfloridian]

61. What if you have major surgery...with a bill in the hundreds of thousands?

And you are just an average person?

[high density]

120. The idea is that the funds in your HSA pays the deductible...

...and the high-deductible insurance pays the rest. I don't see when this is ever economically viable unless the high-deductible insurance is very cheap. At the company I work for, the HMO that covers nearly everything with a $20 copay is very similar in cost to the high-deductible insurance. I have no clue why anybody would choose the latter and then be on the hook for a significant annual deductible, which is often on a per-person basis. It seems like a scheme so that insurance companies can swallow large premiums plus large deductibles while providing only catastrophic coverage in return.

[donco6]

37. No thanks.

The problem with allowing everyone to be able to pick and choose HSAs is that it will greatly increase the premium for those NOT choosing an HSA. It essentially removes that option from the rest of the employees.

When people opt out of the health plan pool, the pool numbers decrease. When that happens, every claim gets applied to fewer people. When the actuaries study the claims history, they will be forced to increase the premium to cover the potential claims. Premiums will rise out of sight and no one will be able to afford it.

An HSA is basically a self-insurance pool that covers the first $XX dollars of your health care costs. All you have to pay for is a second tier insurance that covers everything beyond that - a catastrophic layer, if you will. Here in my school district, we have many, many people who work just for the insurance benefit. If you substitute HSAs, they will have to set aside money they don't have to fund the self-insurance layer. They'll lose any benefit of working for the district.

Sorry, it's a bad idea.

[TwixVoy]

42. Jesus christ on a cross

For the millionth time I am talking about HSAs as in health savings accounts at freaking BANKS not your employers health plan. Here is a link to the type of account I am talking about at freaking Wells Fargo. Can this many people really be this clueless?

https://www.wellsfargo.com/investing/hsa/index

[donco6]

91. You can pull back on the condescension a little.

I'm CFO for a school district with 600 employees. I know a little about the subject.

I'm talking about the same thing you are: An HSA at a bank or whatever investment technique you prefer. If someone is taking part in one of those, they're not going to want to be part of the insurance pool at their work. One less person in the pool at work means the pool's risk increases. The pool's risk increases, the premiums increase. Giving everyone the option of pulling out of the pool will increase the premiums to the point where no one can afford them. This is true regardless of where you're HSA is held.

To build up the HSA at the bank, you have to put your own money in. Or, in the case of most of those I've seen, the employer puts the difference between what he would have had to contribute to a regular premium and the catastrophic layer, which is much cheaper. But the employee MUST contribute something - the diffence between the reg. premium and catastrophic isn't that big. So to build up the HSA, the employee has to contribute money. When your paycheck is already essentially zero (and we have many employees who are in that situation), you have no cash to build up your initial HSA.

I know you love the idea. I have reasons to see it as not such a great thing.

[CAG]

111. Thank you for calling this person out.... They need to take a chill pill

and realize that their situation may not be the same as everyones....

[supernova]

48. Yes, self-financed healthcare

And of course you know what will happen.

Over time, they will "generously" allow to you save MORE and MORE. I can hear the PR now.

We're *raising* our limits so you can SAVE MORE and spend more in 2015!!!

Eventually, you will be saving for and financing ALL of your healthcare and the insurance company will have to pay out NOTHING. They will be indistinguishable from a regular brokerage house.

Meanwhile the problems with vivisectioned risk pools and complicated access will only increase, because HSAs don't begin to address any of those issues.

[supernova]

39. HSA is yet another Repub cheapo way

of saying that they are doing something when in fact it's a great big nothing and a give away to the insurance companies.


We need a National Health Service like the UK or Single Payer like Canada.

[mmonk]

44. You are correct. It's just another way to keep the insurers in the game.

[supernova]

45. I can't believe the OP

is buying into it so easily.

We really have A LOT of work to do educating Americans about what a TOP NOTCH healthcare system should look like.

And no, it's not a pipe dream.

[TwixVoy]

47. And I can't belive you can't read?

For the 100th time I am talking about accounts such as these: https://www.wellsfargo.com/investing/hsa/index That will help you pay for over the counter meds, band aids, other misc medical expense. NOT your employers HSA health plan, and certainly NOT to pay for freaking open heart surgery.

[supernova]

49. I've read all of that on HSAs before

and it is a "solution" that is no solution at all.

It doesn't address any of the fundamental problems in our healthcare system.

It's like the Little Dutch Boy trying to put a band aid over the hole in the Dyke.


It's just another way to get people to finance a larger portion of their healthcare and to pay out less in benefits.

Sorry. It's not worth it.

I don't need an HSA to save money. I'm pretty good at that all my myself. I don't need AETNA's permission to open a savings account.

[TwixVoy]

52. No one said it did

Who the hell ever said an freaking savings account would do that? But it is useful because it allows you to NOT have to pay taxes on things you buy for your medical use.

[supernova]

58. I'd rather we completely change the paradigm

That's the only way to fix our healthcare system.

HSA are just a pitstop to the inevitable.

The only way to lower costs for everyone is to put everyone in the same risk pool, healthy and chronically sick alike.

Costs go down over time and everyone can get the care they need at a reasonable cost per person... not charged at the POS.

[TwixVoy]

65. No you are WRONG

No government program is EVER going to pay for your aspirin. It is never going to pay for bandages. It will never pay for your over the counter claritin. If we make health savings account at BANKS available to ANYONE regardless of health insurance coverage all those items could be FEDERALLY TAX FREE for EVERYONE. Why the hell are you so opposed to that? Are you on the payroll of some big insurance company?

[supernova]

69. Now you're the one hyperventilating

Me, an industry shill?

:rofl:

I never said I wanted the gov't to pay for my aspirin. Either.


I do want us to start on the road to universal healthcare. I do fight for that.

And I'm a big fan of this org:

http://www.pnhp.org/">Physicians for a National Health Program

[TwixVoy]

71. I'll ask you again

why do you think people should pay taxes on items they buy for medical use? It must benefit you in some way to be so opposed to this.

[supernova]

74. No. Here's the thing.

Lowering taxes or forgiving taxes, etc. Is a Repub right tactic to make people "feel" that they are getting a better deal. At least temporarily. But there is nothing to stop the manufacturer from raising their prices by going to the outlet that will sell it the most expensively.

Let's say a walker, standard aluminum with two handles, crossbars and four legs, costs $25 at Rite Aid.

You the individual purchase it. Here in NC the sales tax is 6.5 percent, which would put the total cost at a little less than $28.50. So you pay for it out of your HSA and you get the 3.38 back. Fine.

Let's say we have UHC. The central payment system (however we decide to set that up) collectively bargains with the maker of the walkers to sell them at a discount, say anywhere from $15 to $23 per walker. You've already saved the potential taxes and then some.

That's my point. UHC or Single Payer will be cheaper overall than the piecemeal approach for HSA. It's the power of collective bargaining over making individuals have the same struggle millions of times over.

[TwixVoy]

76. Sorry

Basically your rethuglican like argument is to tax the poor because the fat cats will find a way to screw them over anyway. I don't buy it. Even if the fat cats WILL screw them over anyway I would rather not make it easy for them.

[supernova]

77. Stop calling UHC a Repuke argument

That's completely off the wall illogical.

Are you sure you're not Sanjay Gupta? :wtf:

[TwixVoy]

80. No I am calling your insistance to continue a tax on the poor

for medical costs a repuke argument.

[supernova]

82. You are completely misinformed

about our healthcare system.

And for your information, I am unemployed and don't have any insurance AT ALL at all. Also, I've spent time quality time as a patient and working in a busy Oncology practice at a Top 5 Medical Center.

There's not much about the medical system about which I don't have first hand knowledge.

For your information, "the poor" can't afford even to save for an HSA, let alone paying for too costly premiums for the plans TO WHICH THESE HSAs are attached. It's mostly hand to mouth for them. You are living in a dream world if you think HSAs are a good solution for the working poor.

Universal Healthcare is the solution for all of us, me as well as you, misinformed as you are on this issue. UHC is free at the point of service for everyone.

There is no bill. There. Is. No. Tax.

[tpsbmam]

75. And they're available to people who already have fucking health insurance.....

hellfuckingo! You, like many others on this thread, hit the nail on the head -- does NOTHING to address the fundamental problems. This OP is about as clueless about the state of healthcare in this country as it comes. This does NOTHING for the millions of people who don't have health insurance. HSAs are for people with a high-deductible health insurance plan. And you CANNOT be enrolled in Medicare. What a crock of shit. Fine -- you already have health insurance and it's a high deductible plan, knock yourself out. The rest of the Americans who have nothing or who are on Medicare can go fuck themselves. Of all of the things to bitch about when it comes to American healthcare, this is NOT an issue I give a flying fuck about. How about healthcare FOR ALL AMERICANS! Jesus.

Sorry for my language -- American healthcare hits a nerve, as does this OP.

[mmonk]

72. I have an HSA but was told by the OP I don't.

Too funny.

[TwixVoy]

73. Because you don't know the difference

between an HSA HEALTH PLAN and an HSA savings account at your local bank. Being able to open a health savings account at Wells Fargo has not a damn thing to do with your employers HSA health plan.

[mmonk]

79. I'm self-employed.

I have a Health Savings Account with ACS/Mellon. The HSA plan is through Blue Cross Blue Shield. The premiums have been $720.00 a month. They have just moved to $775.00 a month. When my claims go through the system, they are paid out by taking the money out of the HSA (Mellon) up to when the deductable amount of the plan is met and is 100% deductable. Then all further claims are paid by Blue Cross Blue Shield 100% for the rest of the year.

[mmonk]

81. Now if you propose the government help me with my plan

like an employer does as part of hiring someone, then I'm willing to listen. Otherwise, all it is is reconfiguring health insurance. It isn't doing anything to get my cost under control in the long run.

[MiniMe]

50. If your company participated in a flex spending account program, you could

I get money deducted out of my paycheck pretax and get reimbursed for medical expenses with those pre-tax dollars. Is there a difference between that and an HSA?

[SmileyRose]

53. You lose Flexible spending money at year's end. HSA's roll over for life.

[MiniMe]

56. What advantage is an HSA other than that?

Is it pre-tax dollars in there? I really don't know.

[TwixVoy]

60. Yes

Basically a health savings account at a BANK/Credit union is a tax advantaged account that you can use for any expense related to medical care.

So let's say you go to Bank of America and open a health savings account. Let's say you deposit $500 in the account. Let's say that year you go and use that money to buy aspirin, bandages, rubbing alcohol, use it for your pescription co-pays, etc. You don't pay federal income tax on that $500 AT ALL - EVER.

That is the advantage of being able to open one.

What the people here opposed to making that health savings account available to everyone are having you do is STILL use that $500 to make the SAME purchases over the year, BUT like cold hearted fucking republicans they would have you pay federal income tax on that $500 you used for your medical care on top of that as is the case now.

[Statistical]

106. Yeah it's pretax dollars.

Essentially you can fund it w/ set amount each month from paycheck plus whatever else you want to contribute.
It has some limit like no more than $3000 per year? something like that.

Money is pre-tax so if you are in 25% bracket, 5% state + 9% SS/medi it saves you about 39%.

If you don't use it it just sits there.
You CAN invest it or you can just leave it earning interest like a money market.

Really no disadvantage (much better than FSA which is "use or lose") EXCEPT
current IRS rules only allow you to add money when you are covered by a HIGH DEDUCTIBLE plan. It has to be a certain plan which meets IRS rules.

The OP was just saying open it up to everyone.

Wachovia manages mine and they give me a debit card.

I buy some Zertec just swipe the HSA card (since it was pre-tax money it is like getting medical "stuff" 40% off).

[WillowTree]

103. If you plan well, you won't wind up forfeiting anything at the end of the year.

For example, I need to have a dental bridge this year which will cost me about $700 out-of-pocket. I set up my FSA for this year for $900 so $34.62 will be auto-deducted from my paycheck every two weeks and goes to the account. Between paying a portion of my expenses for contact lenses (my insurance will pay the first $200) and the solutions to care for them and the co-pays on the prescriptions I'll get through the year, I know I'll use up the other $200 before the end of 2009 so I won't lose any of that account.

And there are some real advantages to having a reasonably well planned FSA if it is available to you. First of all, the account is funded with pre-tax dollars, so I won't pay taxes on that $900. Also, you can use any portion of the account at any time in the year. I won't be having the bridge done for a couple of months, but theoretically I could get it this week and be reimbursed out of my FSA for the full $700 now so it's like getting a loan, but not only is there no interest attached to it, I also save on the tax I would have paid on that money, as well. And even if I have a small additional out-of-pocket to pay beyond what I'm putting into the FSA by year's end I'm still ahead of the game. Last year I only exceeded what I alloted to my FSA by $32. I can live with that.

Also, if you max-out your FSA allotment early in the year and then change jobs, it's the FSA that loses out. You don't have to reimburse the plan for what you would have contributed to it for the balance of the year had you stayed with your current employer.

If you can make an educated estimate of what you'll pay during the year for deductibles, co-pays, things you know you'll need that your insurance plan doesn't cover (like Lamaze classes or OTC drugs and medical supplies), you can safely set-up an FSA to cover all or most of it without risking losing any of it and save on your taxes to boot. If your employer offers one, it's pretty silly not to take advantage of it.

[TwixVoy]

54. YES

Because with your flex account you will lose your money if you don't use with. With an HSA account you get to keep it forever for any future medical expense.

[Statistical]

55. HSA doesn't go away.

Flex spending is use or lose.

You can keep money in an HSA forever. Even earn interest.
We should get rid of flex spending account rules (FSA) and simply make them all HSA.

However HSA won't solve the healthcare solution. It is nice to save money tax-free though.

Figure 25% tax bracket + 5% state tax + 9% SS/medicaire = 39%.
Every $1.00 paid from my HSA I would need to earn $1.39 to pay cash for it.

[RB TexLa]

57. Yes, with an HSA you have a high deductible insurance plan and you pay for medical costs

until your deductible is met. If you are healthy and don't spend much on health care you can have good growth of your savings and greatly lower what you pay to the insurance company.

You are basically insuring your self for $5,000 grand worth of health care a year. The less you use the more your account grows.

But the doctors do get some information from the insurance company and you will get letters and even a phone call urging you to have an exam every 6 months or year.

You can still have supplemental insurance within guidelines such as cancer and accident coverage.

[TwixVoy]

63. And this is how we are getting screwed

People should be able to create a health savings account REGARDLESS of what kind of insurance you have. Why make it so you must have crap insurnace to open one? I'll tell you - to benefit the insurance business.

[RB TexLa]

67. It benefits me, I pay much less to the insurance company and my account grows tax free

the less I use the more is there to grow.

They are not for everyone but if you are healthy it can save a lot of money.

[supernova]

78. Typical

I'm not surprised it would be you to say that.

[RB TexLa]

84. Actually I don't understand what you are saying.

[supernova]

86. I don't want AETNA

in charge of my money. Period.

I don't need their permission to open up a savings account.

This thread is really about trying to sell a weak version of "insurance reform.

What insurance companies do you and TwixVoy work for?

[RB TexLa]

88. In a HSA you control how the money is invested

[supernova]

90. Hello!

I'm not employed right now.

I can't afford to put into any kind of healthcare right now. HSAs don't help me one iota.

edit: So you don't deny you work for a medical insurance firm and that you would personally benefit from people opening HSAs.

[RB TexLa]

92. I haven't said they are for everyone.

[supernova]

94. But that's exactly the problem!

There are 46 million people going without the most basic care in this country.

HSAs are for people who are mildly to wildly successful and already have an "I got my insurance, so screw you" attitude. It's all so very simple when you already have resources and options. It's totally predictable that you and TwixVoy would not see the overwhelming need in this country.

Our problem is way too many people don't have any resources at all. HSAs don't address that.

My point is that it doesn't have to be that way.

I'm fighting for UHC. You can sit back and smugly enjoy your little HSA all you want.

I going to get more, for all of us.

[RB TexLa]

95. People having HSAs doesn't prevent a health care solution for those who don't have coverage.

[supernova]

98. I invite you to read this:

http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=389x4768021

[Liberal Veteran]

99. Fix our health care system and HSAs won't be needed.

What's so hard to understand about that?

It's a free-market mirage dressed up as a boon to taxpayers to make it appear as though something is being done to address the real problems.

But it doesn't really do a damned thing to make health care affordable and accessible.

Do you really believe that vast majority of people are sitting out thinking, "If only I could contribute to a pre-tax portion of my income to some account, my concerns about health care would be greatly diminished."

[KoKo]

101. Tell that to my relatives in their 20's who overpayed because Human Resource person

scared them into overpaying into the account which they lost at end of year because they are both young and healthy and have parents with no problems... They lost between them almost $700.00 because they couldn't use what they put in by the end of the year..even with pap smear and a bout with a sinus infection... :shrug: SCAM!

[RB TexLa]

102. That is an FSA, different thing.

[Statistical]

105. Thats an FSA not a HSA. HSA never go away even if you change jobs.

FSA you "use or lose"
HSA is portable. It is like an IRA for "medical costs".

Probably not the best explanation but it works.

My employer contributed $100 per month to an HSA if I picked the "cheaper" healthplan.
I kept it for 2 years and contributed some $$$ myself.

Later when my healthcare needs changed (and job changed and got married) I switched to another plan.
Still have the HSA with some money in it (almost gone now because I can't contribute).

Scrap FSA and replace them with HSA but allow any plan to offer them (not just "cheap plans").

[bread_and_roses]

66. No. We need single-payer national health care

We need health CARE - not health "insurance" designed to make a few people rich and beggar/deny care to the rest of us. HSA's are just another scam designed to undermine the not-for-profit concept of health care, not health "insurance".

[supernova]

70. Thank you

We have a lot of work to do to make it happen.

But it will

:thumbsup:

[annabanana]

83. an HSA is only of use to someone with the enough to put in

ANY KIND of a savings account...

It's a very bad program.

[Liberal Veteran]

85. Yeah, cause nothing will fix our health care system better than a tax shelter.

When people are choosing between putting food on the table and paying their bills on time, HSA's don't do a lot to help alleviate the financial burden.

[supernova]

87. LOL Good one!

:D

[tabbycat31]

89. HSAs are meaningless

for those who don't make enough $$ to pay income taxes.

[tucsonlib]

96. Your Proposal Is Absurd On So Many Levels

Aside from the obvious point that what you're advocating does nothing to address the plight of nearly 50 million uninsured Americans (For example, having suffered a heart attack eight years ago, I can't purchase insurance at any price), you seem to meekly accept such rip-offs as "deductibles" and "co-pays" as unavoidable expenses.
For-profit health care is not only morally and ethically indefensible, it's also economic madness. The rest of the civilized world has long recognized that taxpayer-funded, single-payer, non-profit universal health care is the only way to go. No deductibles, no co-pays, no "supplement" insurance plans, no restrictions.
"Allowing" everyone to have a "health savings account" doesn't even qualify as "re-arranging the deck chairs on the Titanic". It's more like handing out teaspoons to the passengers and promising that all will be fine as long as they keep bailing....

[ThomWV]

97. Fuck that - Universal single-payer healtcare for anyone on our soil - no less

[dpbrown]

104. Universal, Single-Payer Healthcare for all

Cheaper than what we have now and everyone's covered.

I think it's telling that Britain adopted a national health plan in the wreckage of WWII. They knew that it would save money and provide better social stability in a down economy.

[lib2DaBone]

109. Health Savings Account is a Republican gimmick for the wealthy...

We need universal health care for everyone.

"But we can't afford it".

Baloney. Can we afford $10 Billion a month in Iraq? Can we afford $700 Billion to Bankers?

[Vinca]

114. If I wanted a HSA I could have one. What I want is healthcare.

I can't afford the $12,000 a year policy that goes with the HSA. There's nothing at all affordable . . . or healthy . . . about the HSA scheme.

[Romulox]

115. The OP is bullshit. Anything but UHC is just a subsidy to corporate healthcare interests. nt

[MadHound]

116. Better than HSA's, Obama needs to push for single payer UHC.

But sadly, though the majority of Americans support this, though this would help out the business community and the ordinary person, I doubt that Obama or the Democrats will do the right thing.

[surrealAmerican]

117. On the face of it that sounds reasonable, but ...

... it fails to address any of the real problems with health care costs. If your insurance were adequate, there would be no need for a HSA. The problem here is the co-pays and deductibles, which should be eliminated.