ICYMI: WSJ Highlights an ACA Provision that Limits HSAs and Causes New Burden for Doctors

A Wall Street Journal article today highlights a provision in the Affordable Care Act, which restricts people from using HSA’s to pay for over-the-counter medicines unless they have a prescription from their doctor.

The provision, which went into effect January 1, restricts choices for consumers and increases paperwork for doctors. Together these consequences may create higher and unnecessary health care costs.

“Patients are demanding doctors’ orders for over-the-counter products because of a provision in the health-care overhaul that slipped past nearly everyone’s radar. It says people who want a tax break to buy such items with what’s known as flexible-spending accounts need to get a prescription first.”

Highlights of the article are below:

  • The result is that Americans are visiting their doctors before making a trip to the drugstore, hoping their physician will help them out by writing the prescription. The new requirements create not only an added burden for doctors, but also new complications for retailers and pharmacies.
  • “It drives up the cost of health care as opposed to reducing it,” says Dr. Sandy Chung, who rejected much of a 10-item request from a mother of four that included pain relievers and children’s cold medicine.
  • Though the new rules on over-the-counter drugs amount to a small part of the massive overhaul of the health-care system, the unintended side effects show how difficult it can be to predict how such game-changing legislation will play out in the real world.
  • The change also applies to health savings accounts designed for consumers in insurance plans with high deductibles. If fewer people use these accounts to buy drugs, the government gets more tax revenue.
  • When Dianna Greer of San Diego and her son came down with a cold, she wanted a $13 bottle of NyQuil and daytime cold medicine—and she wanted to pay for it by tapping the $5,000 in her flexible-spending account. Later, she got the prescriptions from a doctor at the emergency room, where she was diagnosed with pneumonia.
  • As that larger battle plays out, the over-the-counter provision is emerging as a top target for change. Republicans in both the House and Senate have introduced legislation to repeal it and return to the old system. Asked whether she would support such legislation, Kathleen Sebelius, secretary of Health and Human Services, said: “I’d take a look at it.”

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