Health Savings Accounts

[mexit]

Listening to Steny Hoyer on the House floor.

I have come to the conclusion that Health Savings Acounts could work . . . .

IF . . . .


Every person at birth should be issued a Health Savings Account card (call it a Social Security Card)

with which they can draw indefinitely on a account which is

fully funded

by the federal and state governments

[Locut0s]

1. Isn't that just universal care by another name?

Or is that your point? Sorry sarcasm doesn't translate.

[mexit]

21. Yes and

Yes.

[Warpy]

2. That means if a kid contracts cancer

and has lifelong health problems from it and from the treatment for it, eventually be told "your money has run out, no more medicine for you."

Not only that, by the time he's an adult, inflation will have chewed it down to nothing.

This is an incredibly BAD idea spewed by an ass who doesn't know how things work.

[mexit]

22. You missed the part

where I specifically say "fully funded" and "indefinitely"

[Warpy]

25. If you think that's going to happen

I have a waterfront lot to sell you in NM. You don't have to look at it, just trust me.

[pangaia]

27. sarcasm... sarcasm.....

[Vinca]

3. That's not a health savings account. You're describing humane health care.

An HSA is you - the person who can barely afford rent and groceries - put a percentage of your earnings into a tax deductible account. Kind of tricky there, too, since most people don't file itemized returns. In any case, you build up your HSA until you get sick. Then you drain your HSA, go bankrupt and start all over again.

[brooklynite]

5. But you'll WISELY evaluate your medical spending choices, resulting in competition and lower costs..

...won't you?

[Vinca]

6. Doesn't everyone unconscious on an emergency room gurney??

[dflprincess]

32. Or when you're having chest pains call around to find out which hospital has the cheapest

cardiac care unit?

[guillaumeb]

8. Very well put. But the GOP will describe HSA accounts

as your freedom to freely control your health care.

It is important to emphasize the freedom aspect, not the ridiculous aspect.

[Cal Carpenter]

16. And Freedom isn't FREE!!1!!

(sorry, couldn't resist)

[guillaumeb]

20. I understand. It does make a great, if confusing slogan.

The GOP specialty is, after all, slogans.

[mexit]

23. Thank you

Unfortunately, there is no cure for FREEDUMB.

[guillaumeb]

63. Welcome to DU.

The only cure for ignorance is information.

[greatauntoftriplets]

10. I worked for a company that had HSAs.

If you didn't spend all that you saved within a calendar year, the remaining amount reverted to the company.

[LastLiberal in PalmSprings]

12. If you spent the entire HSA during a calendar year, does the company give you more money?

I didn't think so.

Just another example of a company stealing from its employees (kind of like "comp time" in lieu of overtime pay).

[mopinko]

13. the least they could do is roll it over.

had the same deal.

[greatauntoftriplets]

19. That would have been nice.

[greatauntoftriplets]

17. Of course not!

[central scrutinizer]

15. That's an FSA, not an HSA

Flexible spending account, section 250 account, I think is another name.

[greatauntoftriplets]

18. They called it HSA, whatever it was.

[Ms. Toad]

36. They could not legally call it an HSA, because HSA has a specific legal meaning -

and part of that legal meaning is that they can't take the money back at the end of the year.

[The Velveteen Ocelot]

24. That's an FSA. With a true HSA the money carries over

and it belongs to you. I had one at my old job and I got to keep the money I put in it even after I retired. The catch is that if you take it out of the account, you have to spend it on health care or it's taxable. The other catch is that HSA policies typically have really high deductibles, so by the time you've paid the premiums, deposited money in the account, and used up your deductible, you're quite a bit out of pocket. An HSA is generally a better deal than an FSA because the money carries over, but they're kind of a scam otherwise.

[WillowTree]

47. That was an FSA (Flexible Spending Account), not an HSA.

And they've changed the rules for FSAs so that now you can carry over up to $500.

[haele]

48. That's an FSA

Flexible Spending Account. An HSA is typically similar to a money market account that is supposed to be tax deductible so long as you use the funds on approved medical and dental expenses.
However, like any employer provided benefit, there can be restrictions on rolling it over if you left the company.

Haele

[herding cats]

56. This was my experience, too.

Granted, they were a startup company at the time, but unless I got sick, they banked on me.

[dflprincess]

37. To review: in the United States citizens are expected to

a) put money away for their retirement
b) put money away so they can buy a house
c) if they have kids, put money away for their education (often while still paying off their own loans)
d) put money away for an emergency and, ideally, have 3-6 months saved in case of job loss
and now
d) put money away to pay a medical expenses with cash

All the while trying to cover day to day living expenses with paychecks whose real buying power is shrinking.

In other western countries the citizens get to have a little fun with their money.

[BeyondGeography]

54. America is a ripoff

The stuff you need; housing, health care, food and education, is all much more expensive here than in continental Europe. Rents are up to 30 percent cheaper (or more) in major cities and so is food. The consumer stuff you don't need is cheaper here.

[Skittles]

4. jeez

these ridiculous republicans think that Americans, who can barely afford to save anything for retirement, will now have so many excess dollars to put in HSA accounts....how convenient they're also against unions, minimum wage hike, or anything else that could improve American wages

[Freethinker65]

7. HSAs work great for healthy individuals with lots of disposable income

They are often paired with high deductible health insurance policies. Basically you pay the first 4K or more yearly towards your medical care (at the insurance company's reduced rate if you use one of their pre-chosen providers) with your own money that was up front placed in a tax free account. Once you reach the deductible, the insurance kicks in and you pay something like 20% and the insurance pays 80% until a higher deductible is met when insurance finally takes over 100% until you reach a yearly/lifetime cap. Do not get sick, do not require treatment for chronic conditions, do not have a family, and never have a hospital stay, and the HSA works great! Otherwise any one of these things will deplete your HSA quickly and you will be out of luck, and money. But the money you do not use, rolls over yearly, and is tax free. Feeling lucky?

[Wellstone ruled]

11. Glad you put this up.

Many years ago I worked for a Engineering/Prototyping Job Shop. We did a ESOP and when that went into effect,because of the nature of a ESOP,everyone is subject to Majority Rule. Major loss was Insurance Coverage which was switched to Health Savings Accounts. What a nightmare,remember the deductibles were down right stupid. Something in the range of Thirty Five Hundred per Family per year. And if you did not spend your stipend by the end of the year,even if you do not need to,well that goes by by to the Insurance Under Writing Company. Never again. After three years,was out of their never to look back and to avoid any firm to rely on Health Savings Accounts.

[pangaia]

28. I think the OPer was engaging in a little sarcasm.....

[Freethinker65]

30. Ah? Certainly hope so, but the GOP has been floating the HSA idea as an alternative

And on the surface it does not sound so horrible, if you have a spare couple of thousand a year to fund it (or your employer kicks in some seed money for the account or deductibles) and you do not require many medical services. We as a family had a brief experience with it and are now thankfully back to a job with a more traditional plan which is financially better for us.

[pangaia]

31. See my post...

http://www.democraticunderground.com/?com=view_post&forum=1002&pid=8472314


Of COURSE they 'float' it, They know it is a fucking disaster just waiting to happen for any breathing human being.

But mainly for 2 reasons--
1) because it puts money in the pockets of the corporations that fund their campaigns and expensive dinners and..
2) They just do not believe in helping any other human beings,. it should be every man and woman for themselves and if you don't have the money DIE!!!!!!!

[Freethinker65]

41. Agreed, it forces workers into high deductible policies

The high deductible policies are much cheaper for the employer to offer and they (the employer) pockets most, if not all, of the difference. The insurance companies enjoy the benefit of the consumer paying for a greater overall percentage of any necessary care. The thought of a tax free nest egg growing over the years to fund future medical expenses sounds nice on the surface to some that have not been forced into this type of plan. And as I stated above, the plan is great, until you need to draw down on your HSA and eventually run out of money.
I am for universal healthcare.

[Buckeye_Democrat]

9. If it's like a co-worker's HSA account, maybe. His wife's employer paid the entire premium and...

also provided funds to cover the deductible!

Unused funds stayed in their HSA account and accrued interest, acting as a back-up retirement plan.

[pangaia]

33. What do you mean by 'premium?' Why would an HSA have a premium?

This sounds to me like just regular old insurance.

Accrued interest. And hoe much was that? ten year treasuries are paying like 2.38%.

And if your co-worker needed $450,000 worth of chemo and radiation PLUS spinal surgery, then what?

[subterranean]

55. HSAs are paired with a high-deductible insurance policy.

The insurance is what requires the premium. The HSA is funded with the extra money you have left over after paying the insurance premiums.

[pangaia]

64. Thanks,, I figured this out last night with the help of a poster here.

And a google search... DUH for me, eh !!

[Buckeye_Democrat]

59. It wasn't a flexible spending account (FSA). It was insurance, an HSA.

His wife's HSA had a monthly premium, which her employer paid, and it was attached to a high-deductible insurance plan. In most company-based HSA plans, employees put money into the account with each paycheck and hope enough money accumulates to cover the deductible if they need medical care. He claimed that his wife's employer put enough money into the account to cover the high deductible each year too!

Since they didn't have many medical expenses, and the money in the HSA account accumulated each year, he claimed they had a little nest egg in there.

That's what he told me, anyway. I'd caught the guy telling little fibs over the years (job-related lies to help him avoid extra work), so it's possible he was lying about it.

Edit: I worked in quality assurance, so people tried lying to me a lot -- e.g., "The problem started ten minutes ago and it's sorted out, so you don't need to look through earlier production." I'd look anyway, of course, and usually discover more defective parts. That meant more sorting work. They hated me there! It probably gave me a small taste of what it's like to be a cop (without the death concerns).

[pangaia]

65. Thanks. I especially like your last paragraph. :))

I don't think mr pee pee likes the ethics people either.

[anneboleyn]

42. That is not a HSA (which is just a savings account that will be destroyed by any serious costs)

[Ilsa]

14. HSAs work well for those of us that are older and have

Chronic health conditions and reasonable disposable income. Mine rolls over year to year.

[pangaia]

29. Do you have enough to pay for, oh say.... $450,000 in chemo treatments, radiation treatments,

Last edited Sat Jan 14, 2017, 12:11 AM - Edit history (1)

plus spinal surgery, a bone marrow transplants and a taxi ride home?

[taught_me_patience]

35. HSA doesn't mean that there is no insurance

it usually means you have insurance with a very high deductable. You pay out of pocket until the deductable kicks in, then insurance starts paying. There are usually out of pocket maximums per year. Mine is 6k for our family. If the bill is 500k, you only end up paying 6k.

[pangaia]

38. Humm,, interesting.

So, where does the savings account part come in?

Do you mean if you, for example, put away $5000 in the savings account, that is tax deductible, and then you can use that to pay the deductible?

[dflprincess]

44. Yes but

For 2017 the maximum amount an individual can put in their HSA is $3,400 ($4,400 if you're 55 or older); family max in $6,750.

The maximum annual deductibles for a High Deductible Health Plan (HDHP) are $6,550 (individual) and $13,100 (family).

So, if you have an expensive chronic condition or you just moved to a HDHP your "savings" account, while still pretax dollars, may not cover your out of pockets.

[pangaia]

46. That is kinda my point.

I did just google HDIPs in New York State, where I live, just for a few examples...

So I understand it better..

I have Medicare with a gap plan so it doesn't affect me, at least not yet. :&gt )

But was/am curious about the details..
SINGLE PAYER !!! MEDICARE FORE ALL...!!!

[taught_me_patience]

45. Yes exactly

I'll give you a detailed breakdown of my insurance and why it is beneficial:

traditional PPO plan for family ($300)

HSA for family
Cost $150/mo
Employer contributes additional $750/yr to the HSA
I contribute an additional $150/mo to the HSA (pre tax and equal to the cost of the traditional PPO)
Deductible $3000
Once deductable is hit, then I'm responsible for 20% of the bills until I reach the yearly max
Yearly out of pocket max 6000

My yearly contribution to the HSA + employer contribution is $2,500. I can use this to only pay for deductables and medicine. Yearly exam and child preventative visits are free (thanks ACA!)

We had one sick visit that costed $65 and a visit to and ENT that was $85 and some medicines that totaled about $75. Negotiated rates for visits are well below what you think they might be. Total HSA expenses were about $200 paid from the HSA.

The end result is that for the exact same price as the traditional plan, I now have 2,300 in an HSA that is rolled over to the next year and if not used, can be eventually invested and taken out in retirement. After three years of employment, I've saved up over the 6,000 out of pocket max. Even if I get cancer and have a 500k bill, I'll still be ahead of where I would have been with a traditional plan.

[pangaia]

49. Got it.

So, if one were self-employed, as I was, or did not have ins through an employer, then the individual would be responsible for paying for those various expenses , correct?


Do you pay $150/mo into the HAS PLUS $150/mo in premiums?

I just checked just a few NYS HDIP facts, and your rates seem pretty good, even if YOU alone had to pay the full $2550/year into the HSA.. You deductible is lower than the ones I saw, but I just check a few local ones...

[taught_me_patience]

51. correct

My employer subsidizes the premiums for our insurance. I pay $150 for premiums plus $150 for the HSA. I do that in order to match the cost of the traditional PPO ($300).

Single payer would be much better, but you gotta live with what you got. For many, including those with families, an HSAs can be a good option compared to traditional PPOs.

[pangaia]

53. I never in a million years thought I would ever see anything good in an HSA,

but realize I didn't understand it.

Well, as you might say, it sure is better than...some other things, and worse than the ideal.
Thanks for taking the time.

[pangaia]

40. OK,, just googled it.. I got it...

it's still a racket, isn't it.

SINGLE PAYER !!

[onecaliberal]

26. Single.Payer.

[dflprincess]

34. HSAs are another Wall Street scam

once you have $3 or $4 thousand in one you can invest the money in a mutual fund - just like your 401K!

Just hope the market is up when you need that bypass surgery.

[taught_me_patience]

39. HSAs are great and are a better choice for most than most traditional plans

especially if you are under 50 and relatively healthy. The money you save rolls over every year and eventually builds to a nice little savings that you could weather a sustained chronic condition.

[anneboleyn]

43. Um, no. One MRI costs 5k. Treatment for heart disease, diabetes, or cancer would wipe out

a "HSA" (just a savings account) very quickly as treatments run into tens of thousands of dollars (and heart surgery? Chemotherapy? A broken bone that requires some surgery? Forget it). A "nice little savings" would be wiped out in no time.

[taught_me_patience]

50. Actually, you pay the insurance negotiated rate

which is way below what you think it is. An MRI is NOWHERE near 5k. A typical radiologist is paid $60/MRI and the practice might collect 80/MRI. Total cost of an MRI is typically about $600.

[Yavin4]

58. But they're going to charge you the insurance rate for the MRI.

No?

[Yavin4]

57. You've never had any medical bills have you?

You have no idea how expensive even the most mundane medical procedure can be.

[Dave Starsky]

60. This person has no clue.

They'll find out how it really is, eventually.

[stopbush]

52. 69% of Americans have less than $1000 in their savings accounts.

21% of Americans don't even have a savings account.

We are not a nation of savers.

The idea that even a small minority of Americans would have the wherewithall to start a HSA - that would need to be off-limits from borrowing against for non-health needs if one wants to amass the kind of $ one would need to pay for a major health condition - is insulting and ludicrous.

Another scam that the Rs will sell to the pathetically ignorant Americans.

[HoneyBadger]

61. What if you are not born here?

[DeminPennswoods]

62. Inadvertently got into an HSA last year

During open season for health care plan selection, I inadvertently picked a plan that was an HSA because I wanted a cheap premium for the year (I am - knock on wood - relatively young and healthy). I never contributed a dime to my account, but it's been interesting to see money added to the HSA every month. I'm assuming that's the over-and-above what the policy actually costs and is over $100/mo more than than my premium. It's also been interesting to see the monthly charges like paper statement and account servicing fees. I've since switched back to a FFS plan and expect to get my money back now that I'm no longer in that plan.