As the pandemic continues, contributing to rising inflation and looming economic recession, Americans from all walks of life may be concerned about their medical bills.
The Freedom Care Actproposed by Rep. Chip Roy (R-Texas), is trying to help Americans regain control of their healthcare costs by creating “health freedom bills” similar to existing ones health savings accounts. Health savings accounts allow patients to save pre-tax dollars for future medical expenses, but are limited to only those on a high-deductible health plan and contain numerous restrictions on what types of health care expenses can qualify. Roy’s bill would allow any American, regardless of health insurance type, to qualify for health freedom bills, expanding the list of qualified medical expenses.
As a physician, I call on Congress to pass this legislation to give patients more autonomy over their health care.
Health savings accounts were first opened in 2003 as part of the Medicare Prescription Drug Improvement and Modernization Act and became more common as more employers began offering high-deductible health insurance over the past 20 years. Many patients on high-deductible plans never meet their annual deductible and thus are forced to use money from their health savings account to cover their routine medical expenses; for these individuals, any money they or their employer spend on insurance premiums is wasted. To make matters worse, current regulations also prohibit the use of health savings accounts to pay for insurance premiums. These policies only serve to enrich insurance companies at the expense of patients and private employers.
Currently, HSAs allow maximum family contributions of up to $7,300 per year into a tax-deductible account, so that the premiums for that year are untaxed. In addition, the money grows tax-free and can be deducted from the account untaxed. These tax-protective mechanisms are how HSAs came to be known by the coveted descriptor “triple tax-free.” In addition to allowing all Americans to get an HSA/HFA, the Healthcare Freedom Act would nearly double the annual contribution limit to $12,000, and allow individuals age 55 or older to contribute an additional $5,000. These changes are necessary because of the rapid growth in health care costs, which routinely outpace already astronomical inflation.
The Healthcare Freedom Act would also expand the list of approved medical expenses to include insurance premiums, direct primary care doctor subscriptions and payment to Healthcare Sharing Ministries. The bill would allow money from HSAs to be spent on all of these expenses, plus additional services that may not be covered by health insurance. For example, patients who come to dermatology clinics can use money from their HSA/HFA to pay for the removal of benign skin lesions or other procedures considered “cosmetic” by insurance companies. From the physician’s side, it offers a wider range of practice opportunities allowing physicians to practice more personalized medicine.
If HFAs become commonplace, more patients will be able to obtain their medications through compounding and specialty pharmacies, eliminating middlemen and reducing costs. Indeed, doctors will be able to bypass insurance headaches such as step therapy (requiring patients that certain categories of drugs do not work before insurance covers alternative therapies) if patients can pay for their drugs directly. As a dermatologist, I regularly use direct-to-consumer pharmacies to help patients get therapies tailored for their skin.
Healthcare freedom accounts would expand access to these services to patient populations who may not have the financial ability to pay for these treatments out of pocket. Employers can also enjoy the added flexibility of HFAs, as they can offer the new health savings account as an employee benefit without being forced to subscribe to a group health plan with high deductibles.
The net effect of expanding the number of approved expenses would be greater patient and physician autonomy. On the patient side, the Healthcare Freedom Act allows them to spend their hard-earned savings in a way that best aligns with their values.
As a physician, I look forward to serving patients based on the ideals of the Hippocratic Oath rather than following arbitrary insurance company guidelines.
Aamir Hussain is a physician in training in Washington, DC. Rufus Sweeney, a medical student at the University of Wisconsin, helped create this story.