Nearly 6 years after the implementation of the Affordable Care Act (AKA the ”unAffordable Care Act,” AKA “the ACA”, AKA “Obamacare”), it appears that this administration is trying to get HSA-qualified plans off the state health insurance exchanges. New regulations published on March 8, whether intentionally or not, will effectively kill HSAs (Health Savings Accounts) on the state exchanges.
It’s already a tough landscape for HSA-qualified plans on the exchanges. Currently, there are no regulations in place that require labeling “HSA-qualified” plans as such, making it difficult for the consumer to identify those policies. And there’s also no requirement to provide information to consumers about how to open an HSA, or how to contribute to it once it’s open.
Two new rules, set for implementation in 2017, most likely represent the “nail in the coffin” for HSAs on the exchanges. The first changes deductibles and out-of-pocket limits for the standard bronze, silver, and gold plans offered on the exchanges, and these are outside the limits for HSA-qualified plans.
The second is a change to what policies must cover prior to the deductible being met. HSA plans, by definition, only cover wellness visits as “first-dollar” (before the deductible is satisfied)benefits. With the new regulations, exchange policies must cover a limited number of primary-care visits, specialist visits, mental health and substance abuse visits, urgent care visits, and certain prescription drugs. Since HSA qualified plans only cover these items once the deductible is met, you won’t see these plans being offered on the exchanges.
Who does this affect? It affects all of the people who qualify for a subsidy to pay their health insurance premiums, since in order to use their subsidy, they must shop for coverage on their state’s exchange. This effectively prevents these people from purchasing an HSA-qualified plan, and reaping the tax and savings benefits associated with it.