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Protect Health-Care Access for Disabled Americans

This article was published by the National Review and can be viewed online here.

Last summer, the American people voiced their dissatisfaction with health care plans under consideration, but it is now clear that congressional leaders are not listening to their concerns. The Baucus plan, reported out of the Senate Finance Committee two weeks ago, is the latest “reform” effort that will reduce, not increase, access to quality affordable health care. In particular, disabled Americans and their families will be severely penalized by this proposal, which will saddle them with new costs and a much greater financial burden.

Flexible spending accounts, deductions for medical expenses, and high-premium health plans — all effective tools for families caring for disabled individuals — would be harmed by the Baucus plan.

In order to raise revenue, the Baucus plan caps contributions to flexible spending accounts (FSA) at $2,500. (This cap is also included in the health care bill just introduced in the House by Speaker Pelosi.) Families caring for those with disabilities are heavy users of FSAs offered by employers. These accounts allow employees to pay for out-of-pocket health care and dependent-care expenses with pre-tax dollars, currently unlimited by federal law. Capping these accounts at $2,500 would effectively cost these families hundreds of dollars a year in additional taxes. For example, for a family with a taxable income of $66,000 per year that currently contributes $5,000 each year to a tax-free FSA, the new cap would result in a whopping $816 in new federal taxes. Furthermore, since the cap is not indexed for inflation, the value of a $2,500 contribution would fall to less than $1,700 within ten years.

The Baucus bill would also raise the threshold for deductible medical expenses from 7.5 percent to 10 percent of gross income. That, too, would negatively impact families caring for disabled individuals: for a family with allowable medical expenses of more than $6,600 (which is very likely for most parents of children with special needs), raising the threshold from which they can deduct medical expenses from their gross income will cost $539 in income and payroll taxes right off the bat. Combined with the FSA limit, then, this family would face $1,355 in new taxes by 2013.

If that wasn’t enough, parents of children with special needs are also more likely to rely on a “high-premium health plan” (a plan that provides more coverage and therefore costs more than a standard plan). The Baucus proposal imposes yet another large tax on such “high-cost” plans. Depending on their coverage, families who have such a plan can expect a punitive tax of 40 percent. Also, as a result of cost inflation in health care, the tax will hit everyone eventually. In fact, most health plans providing good coverage today would be subject to the new tax sometime in the next few years.

Should Congress really be trying to finance health care reform on the backs of families who are already carrying a substantial financial burden? Isn’t it ironic that a mandate to make health care more affordable for the most vulnerable Americans has morphed into a tax hike on those with disabilities and their families?

Instead of making it harder for families with high medical expenses to deduct those costs, we should be making it easier. Rather than making tax-protected FSAs essentially worthless, we should be encouraging their use, albeit with more efficiency.

While health reform is a worthy goal, we shouldn’t pay for it by taxing those who already have high medical costs because they or someone in their family has a disability. That would defeat the very purpose of such reform. And we can’t allow it to happen.

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