HSA Doomed?

[jbage007]

New York Times

"Not only did many House members and senators decide to leave the accounts alone, but the president also came around, too. Earlier this month, in an effort to appease Republicans, he declared his support for also making H.S.A.'s available to people who would buy eligible insurance through the federally regulated insurance exchanges."


(from second link)
"Obama also said he believed that high-deductible insurance policies, used in conjunction with health care savings accounts, could be offered to consumers in new federally regulated exchanges, or marketplaces, that would be created by his legislation."

 

[Ann H]

Rather than kill off HSA's, it's more likely that Congress would tweak the IRS rules to allow qualified HSA's to provide 3 Dr. visit copays and other required changes. That's what I suspect would happen at the Federal level, anyway. California is another issue altogether.

 

[Yagents]

I didn't realize that HSA's are also under attack due to the MLR provisions alone. Read page 6 of this testimony from Galen Institute:

http://smbiz.house.gov/UploadedFiles/Turner_Testimony.pdf

 

[sdmillar]

I didn't realize that HSA's are also under attack due to the MLR provisions alone. Read page 6 of this testimony from Galen Institute:

http://smbiz.house.gov/UploadedFiles/Turner_Testimony.pdf

Interesting how they point out that the MLR actually discourages carriers from putting efforts toward fraud prevention. Just like any government program they would rather turn a blind eye to the fact.

 

[stuy119]

Won't that effect any plan with a deductible, not just HSA's? The way it was written means that it's an attack on deductibles, period, which means that it's being recommended that there be 0 out of pocket costs (more usage ...).

Ah, this is going to be a fudged up situation for quite a few years.

 

[AllenChicago]

Won't that effect any plan with a deductible, not just HSA's? The way it was written means that it's an attack on deductibles, period, which means that it's being recommended that there be 0 out of pocket costs (more usage ...).

Ah, this is going to be a fudged up situation for quite a few years.

My thoughts exactly, Stuy119. Why did the testimonies focus on how the MLR affects HSA's and not ANY health insurance plan with a deductible? All the wellness stuff is now paid for by the insurance company. Certainly those free physcials, colonoscopies, mammograms, etc. expenses are the same whether we're talking an HSA, or non-HSA qualified health policy. And, since medical tests, treatments and hospitalizations cost so much, it shouldn't be hard at all for health insurance companies to pay out 80% of their premiums in medical costs.

I just think it stinks to high heaven for the United States Government to tell ANY privately owned for-profit corporation how much profit it can make without being penalized. That's the first step in the making of a freedom-robbing dictatorship, IMO.
-Allen

 

[Yagents]

High deductible with a copay plan may have a higher MLR payout for medical expenses.

Also, where's the incentive for the insurance company to negotiate lower network discounts, which of course becomes a benefit for those with HSA's? I'm sure the network price negotiator is not considered a medical expense (just like the anti fraud employee), and it makes it easier to hit the 80% if you fire that person, and let network prices drift higher.

My medical costs would be much higher without those network discounts.

 

[somarco]

High deductible with a copay plan may have a higher MLR payout for medical expenses.

Where did you get that?

where's the incentive for the insurance company to negotiate lower network discounts,

Network "discounts" are identical regardless of plan design.

 

[Yagents]

Bob, I'm just logically thinking it through.

If copay, client pays $35, and insurance company pays $50 which goes towards the 80%.

If no copay, client pays $80 discounted price. $0 goes towards the 80% MLR.

Yes, discounts are the same within the same insurance company. But, where's the incentive to get lower discounted rates for their customers. The salary of that negotiator goes in the 20% of the MLR. And if they are successful in gettting a lower price, it will hurt the 80% ratio.

Or, my math may be wrong since it is based on total premium paid.....but concept still applicable. No incentive to lower prices or reduce fraud.

 

[somarco]

where's the incentive to get lower discounted rates for their customers

Without discounts the policyholder hits the deductible much quicker.

Carrier doesn't pay one rate to provider below the deductible, with or without copay, and another above the deductible.

You are confusing network pricing with LCM.