Increase HSA contributions, investments and options; educate the public about for profit insurance

Health
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Edit 12/02/24

Health Savings Accounts should be available with increased contribution and investment options to any employee who receives insurance options through employment so that they have the freedom to choose how to spend their money.

These accounts should have the same privilege as an insurance company to invest in the stock market in order to increase and sustain funds for the individual if they choose. This should be built around a safety net.

HSAs will cut costs for providers who will then be able to offer services at cash fee amounts. This saves the patients and providers money. We see this in business models where a shoulder surgery is offered at a cash only facility versus at a facility that accepts insurance. The insurance model increases costs because they create costs for the facility in efforts to get paid. The cash model is able to offer the surgery for less money.
In order for citizens to make informed decisions and have the freedom of choice to use the best care they need to understand for profit insurance is largely based on investors as stakeholders. We need to understand that the underwriter makes decisions about which providers and which treatments to cut out of policies based on cost not based on quality of care and necessity.

Transparency from for profit insurance and underwriting is necessary in order to understand what citizens are agreeing to when they give up a portion of their salary for insurance. Insurance should not be able to use terminology such as quality control and preferred provider and terms of this nature to mislead the public into thinking this is anything more than cost control.

The public has grown to expect insurance to pay and are shocked when it does not because they lack the knowledge of what for profit insurance goals are as a business industry. Insurance companies intentionally deny bills they know should be paid in order to prolong having to pay out and in hopes that nobody will make the effort to get the payment thus may not be paid at all. Insurance Corporations invest premiums in the stock market to increase profits. The investors and market set standards for that profit. Therefore, the Insurance Corporation needs to hold onto money by not paying out for claims. They will also eventually have large payouts for catastrophic illness/injury such as cancer and paralysis. Therefore, they must also keep as much money as possible to reduce risk and maintain profit. The for profit insurance industry cannot and will not pay for all care because it would not be able to then pay for very expensive payouts for emergency care and chronic life threatening care. It is not realistic and citizens need to be given the information to understand this concept so they can take the actions to prepare for medical expense.

Solutions:

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Citizens need to be informed and provided with the option to have an HSA with various deductibles of their choice so they can actively save their own money for healthcare costs.

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For profit insurance should cover emergency and chronic life threatening illness only.

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All other care should be covered by HSA or a similar product that provides freedom of where to spend their money.

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HSAs should permit significant increased contributions and investment options. The current limits are too low for the reality of what healthcare may cost especially if someone is ill.

Conclusion:
The public should always be given the choice to use an HAS with increased contributions and investments that meet the realistic costs of care and take various size deductibles while also saving on their own just as they save for their auto repairs, groceries, rent, and vacation. The employer may provide pay for vacation time but they do not pay for the actual vacation trip. This is the same concept. If employees want to put additional money into their HSA they should be given that option.
Therefore, options for better HSAs should be made available for all citizens. This should also include citizens who are independent contractors or small business owners through Associations and groups.

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Merge

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See linked article

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They are working on getting rid of taxing people on Social Security. Trump announced this during the election. So I would take them being subject to taxes out. They already paid taxes their entire lives.

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I will add the continued contributions and expanded wellness care with freedom of choice to the above plan. Is there anything else that would be new that I am missing?

Currently * Once you turn 65, you can use HSA funds for any purpose, including non-medical expenses.

  • Six months before retirement or Medicare enrollment, you must stop contributing to your HSA.

*Expanding this so there is no age limit to allow continued contribution is a good idea.

Data would need to be defined to protect people’s privacy and rights. Give them an inch and they will take it all.

Medicare also needs to be amended in that the Government currently spends money from the Medicare fund to pay down Government debt for nothing related to healthcare/Medicare at all. There is a separate policy for this already. I’ll post it on a separate response.

**Some wellness and preventative care is already permitted for HSA use. That includes some Alternative Care providers. ***However, this *could be looked into and expanded and allow more freedom of choice. ****

*Currently the following are permitted with HSAs:

Caregivers can contribute to an HSA for a relative.

According to the IRS, a caregiver can claim a tax-dependent relative (such as a parent, grandparent, aunt, uncle, or qualifying relative) and use their own HSA to pay for their qualified medical expenses. The relative must meet specific IRS requirements, including:

  1. Being a qualifying relative (e.g., father, mother, father-in-law, mother-in-law, grandparent, aunt, or uncle)
  2. Living with the taxpayer for the entire year as a member of their household
  3. Having more than half their total financial support for the year coming from the person claiming them as a dependent

Once the relative meets these criteria, the caregiver can use their HSA to pay for qualified medical expenses, such as home health care, assistance with eating, bathing, and medication management, for their dependent relative.

It’s essential to note that the caregiver must be the one claiming the relative as a dependent on their tax return and must have an HSA account in their own name. The HSA funds can be used to reimburse the caregiver for expenses incurred on behalf of the dependent relative.

Additional details:

  • The IRS clarifies that HSA funds can be used to pay for qualified health-related expenses for dependents, including those claimed on the caregiver’s tax return.
  • The caregiver can contribute to their own HSA and use the funds to pay for expenses incurred on behalf of their dependent relative.
  • The HSA account must be in the caregiver’s name, and the caregiver must be the one claiming the dependent relative on their tax return.

In summary, caregivers can contribute to an HSA for a relative who meets the IRS requirements for a qualifying dependent, and use the HSA funds to pay for qualified medical expenses incurred on behalf of that relative.

The HSA allows much more freedom already which allows users to put money toward wellness.

Currently HSAs can be used for nursing home expenses:

"HSAs (Health Savings Accounts) can be used to pay for nursing home expenses, but with certain conditions and limitations.

IRS Publication 502: According to IRS Publication 502, Medical and Dental Expenses, nursing home care expenses are eligible for reimbursement from an HSA if they are:
    Required by a chronically ill individual
    Provided as part of a care plan prescribed by a licensed healthcare practitioner
Long-term care services: HSA funds can be used to pay for qualified long-term care services, including:
    Residential nursing home care for medical reasons
    In-home nursing services connected with patient care
Limitations: HSA funds cannot be used for non-medical expenses, such as room and board, in a nursing home. Only medical expenses related to the individual’s care plan are eligible.
Premiums: HSA funds can also be used to pay for long-term care insurance premiums, subject to age-based limits.
Documentation: To ensure IRS compliance, it’s recommended to maintain itemized receipts and documentation for HSA reimbursements, especially when using HSA funds for in-home care provided by family members.

In summary, HSAs can be used to pay for qualified nursing home expenses, but only if they are medically necessary and part of a prescribed care plan. It’s essential to understand the specific rules and limitations to avoid potential tax penalties."

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