There is much not to like about Obama Care (Patient Protection and Health Care Affordability Act) , but this post will focus on just one.

HSAs or Health Savings Accounts are actually a part of a health insurance option that includes a High Deductible Health Plan (HDHP) option. Before Obama Care a plan was designed that allowed a consumer to buy a policy with a large deductible that also qualified for a tax deductible savings account (HSA). The idea was to bring consumer pressure to bear on the medical market place. By allowing health insurance buyers to pay more out of pocket they would become more cost conscious.

Accumulation of funds in the health care savings account could roll over and be used to pay future bills, but the crux of the intention was that the consumer would be spending his own health care dollars and saving insurance for major medical expenses. This was one of the few reforms in health care that sought to increase consumerism.

But the higher deduction was also largely offset by much lower premiums because consumers were willing to pay more out of pocket. This is how insurance should work.

But Obama Care has mandated first dollar coverage on preventative care even for HSAs where consumers chose to pay first dollar costs themselves in order to get lower premiums. Preventative care is also being expanded to include more than just physicals; it now includes birth control pills and family counseling. The wider interpretation of ‘preventative’ has companies concerned about what else will now be similarly considered and thus forced to cover at 100%.

The result is that now HSAs are no longer a low cost option. On our renewal this year our HSA option is about the same cost as an HMO. There is no room left to fund the tax deductible health savings account. HSAs now appeal to either the very healthy who get their annual physicals covered at 100% or the very sick who will reach their maximum out of pocket anyway, and may actually have few copays in such a high deductible plan.

By mandating what they think we need rather than what we would freely choose, they have reduced our choices and increased our cost.

Now they this bill has passed, the more we get to see what is in it, the more we are not going to like it. Using the word ‘affordability’ in the title of this bill is an Orwellian joke.

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