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The Health Care Freedom Act is an essential solution to runaway medical debt

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 Healthcare Freedom Act, proposed by Rep. Chip Roy (R-Texas), seeks to help Americans regain control of their health care expenses by creating “health freedom accounts” similar to existing health savings accounts. Health savings accounts allow patients to save pre-tax dollars for future medical expenses, but are limited to only those with high-deductible health plans, and contain numerous restrictions on what types of health care spending can qualify. Roy’s bill would allow any American, regardless of their health insurance type, to be eligible for health freedom accounts, as well as expand the list of qualified medical expenses.

As a physician, I urge Congress to pass this legislation to provide patients with greater autonomy over their health care.

Health savings accounts were first established in 2003 as part of the Medicare Prescription Drug Improvement and Modernization Act and have become more common as more employers have begun offering high-deductible health plans over the past 20 years. Many patients with high deductible plans never meet their annual deductible, and are therefore forced to rely on money from their health savings account to cover routine health expenses; for these individuals, any money spent on insurance premiums by themselves or their employer 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 to a tax-deductible account, allowing the contributions to be tax-free for that year. In addition, the money grows tax-free and can be withdrawn from the account tax-free. These tax-sheltering mechanisms are how HSAs became known by the coveted description “triple tax-free.” In addition to allowing all Americans to get an HSA/HFA, the Health Care Freedom Act would nearly double the annual contribution limit to $12,000 and allow individuals 55 or older to contribute an additional $5,000. These changes are necessary because of the rapid growth in health care costs that regularly exceed the already astronomical rate of inflation.

The Health Care Freedom Act would also expand the list of approved medical expenses to include insurance premiums, direct primary care physician subscriptions and payment to Healthcare Sharing Ministries. The bill would allow money from HSAs to be spent on all of these, 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 side, this allows a wider range of practice possibilities that will enable physicians to practice more personalized medicine.

If HFAs become commonplace, more patients will be able to obtain their medications through compounding and specialty pharmacies, cutting out middlemen and reducing costs. Indeed, doctors would be able to circumvent insurance headaches like step therapy (requiring patients to fail certain categories of medications before insurance will cover alternative therapies) if patients could pay directly for their medications. As a dermatologist, I regularly use direct-to-consumer pharmacies to help patients find customized therapies for their skin.

Health care freedom accounts would expand access to these services to patient populations who may not have the financial ability to pay out-of-pocket for these treatments. Employers may also like the added flexibility of HFAs, since they will be able to offer the new health savings account as an employee benefit without being forced to enroll in a group high-deductible health plan.

The net effect of expanding the number of approved expenses will be increased patient and physician autonomy. On the patient side, the Health Care Freedom Act allows them to spend their hard-earned savings in a way that is most consistent with their values.

As a physician, I look forward to serving patients based on the ideals of the Hippocratic Oath rather than following arbitrary guidelines created by insurance companies.

Aamir Hussain is a resident physician practicing in Washington, DC. Rufus Sweeney, a medical student at the University of Wisconsin, assisted in the creation of this story.

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