GOP Pledge-O-Meter

Expand health savings accounts

Will "improve Health Savings Accounts by making it easier for patients with high-deductible health plans to use them to obtain access to quality care."

Subjects: Health Care


Little hope in this Congress

As part of their "repeal and replace” answer to Obamacare, Republicans have pitched a number of ideas including the expansion of health savings accounts.

Generally speaking, these accounts let workers set aside earnings before taxes to pay for out-of-pocket medical expenses, such as doctor's office co-pays and prescriptions. They are also sometimes called flexible spending accounts, which have similar rules.

But like all the other Obamacare alternatives, this one isn't moving. The House passed a bill in June that, among other things, would lift the restriction on HSAs to allow them to be used for over-the-counter drugs. Another bill, called the Health Savings Accounts Improvements Act of 2012, would relax a number of restrictions on the accounts. Yet another would allow contributions to be rolled over from one year to the next. Currently, many accounts have a "use it or lose it” provision.

The biggest impediment to any of this legislation advancing: Obamacare itself. The health reform law caps yearly flexible spending account contributions at $2,500. And Democrats, who control the Senate, are unlikely to chip away at President Barack Obama's signature law.

Jody Dietel, chief compliance officer with WageWorks, Inc., a leading provider of flexible spending and health savings plans, said she doesn't expect any legislation on health spending accounts to make it through the current Congress.

"I think the Democrats don't want to do anything that's viewed as weakening (the Affordable Care Act), even though the president said if there's tweaks to make, we will. And I think to some extent, Republicans only want to talk about repeal,” Dietel said.

With no foreseeable action on this issue, we rate it a Promise Broken.


Interview with Jody Dietel, chief compliance officer with WageWorks, Inc.

Email interview with Sarah Swinehart, spokeswoman for Rep. Dave Camp, Aug. 14, 2012

THOMAS, H.R. 436 Health Care Cost Reduction Act of 2012, Jan. 25, 2011

THOMAS, Health Savings Accounts Improvements Act of 2012, May 29, 2012

THOMAS, Health Flexible Spending Arrangements Improvements Act of 2012, March 10, 2011

New York Times, "Cracks Appear in Republican Unity on Health Law Repeal,” July 10, 2012