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The Hill - Restoring Financial Flexibility in Healthcare


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By Sen. Mike Johanns (R-Neb.) and Rep. Erik Paulsen (R-Minn.)

Three years to the day after President Obama signed into law his massive healthcare overhaul, the Senate overwhelmingly approved a measure to repeal two provisions limiting families' freedoms. For a brief moment in Washington, politics took a back seat, and the needs of nearly 33 million Americans were addressed.

These families, who take the initiative to budget for their healthcare expenses using flexible spending accounts (FSAs) or health savings accounts (HSAs), were some of the first to feel the impacts of the president's health law. It requires them to obtain a doctor's prescription to purchase over-the-counter (OTC) medications with their own money set aside specifically to cover health-related expenses. Beginning this year, it places a $2,500 cap on FSA contributions, limiting families' abilities to use specialized accounts to pay for medical expenses sometimes not covered by health insurance.

The amendment that passed as a part of the Senate budget resolution mirrors legislation we recently introduced to restore fairness and flexibility for the millions of Americans affected by these mandates. The Family Health Care Flexibility Act reinstates the original functions of these plans by eliminating the HSA and FSA prescription requirements for OTC medications and removing the arbitrary FSA cap. Recognizing the need to restore flexibility, the Senate approved this legislation in a bipartisan fashion.

Without repealing these restrictions, patients in need of real medical care must endure longer waits as physicians' schedules become cluttered with folks seeking OTC prescriptions to remedy minor maladies. Doctors are already in short supply, and demand will dramatically increase next year when 30 million more patients enter the health care market because of the law.

But the health law's penalties on these families don't stop there. The new cap, limiting FSA annual contributions to a mere $2,500, places significant burdens on families with expenses that may not be covered by their insurance. Families who once used their FSAs to budget for their child's braces, an expense that could cost $7,000, are now stuck finding other ways to cover these costs.

This arbitrary cap is especially difficult for families who have children with special needs. Specialized education for these children can cost up to $14,000 a year, well above the new FSA annual ceiling. The National Down Syndrome Society and the National Center for Learning Disabilities both back our legislation to remove these barriers for families budgeting to help their children reach their potential.

Neither restriction improves healthcare access or quality. They are ploys aimed at making the $2.6 trillion health law look less costly by collecting more taxes from folks who plan ahead for their health care needs. Rather than denying flexibility so many American families depend on, Washington should work to promote and protect programs that help lower the cost of healthcare and allow individuals to make better healthcare choices.

Republicans and Democrats alike can appreciate the common sense in restoring a thoughtful approach to healthcare. Lawmakers on both sides of the aisle represent a growing number of Americans becoming ensnared in costly and burdensome provisions slowly rolling out as a result of the health law. And as the law's mandates become more and more evident, public support continues to disintegrate.

We applaud the Senate for giving this legislative fix a chance, especially when doing so can be politically difficult. Despite partisan differences in Washington, constituents across the country are in need of these changes, and their Senators did not stand in the way. While the Senate budget resolution will likely never become law, our HSA and FSA legislation stands on its own merits, and those who supported it as an amendment should support its passage into law.

These health law mandates are just a couple examples of new challenges raised over the past three years with undoubtedly more to come. Restoring Americans' faith in our healthcare system will require a departure from government gimmicks and a return to common sense. The political battles have been fought and refought. It's time now for sound policy to win out, and for lawmakers to take a closer look at this law without a red or blue partisan lens.

Ending the unfair FSA and HSA requirements would be a great addition to the 1099 paperwork mandate that has already been repealed. Congress should send a message to families who have children with special needs that we are going to step up and do the right thing. Surely we can all agree letting families use their money as they see fit and freeing up doctors to treat the sick is a positive step for real health reform.

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