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One of the ways congress is proposing to fund Obamacare is by putting a cap on Flexible Spending Medical Accounts. For those who are not familiar with those accounts, they allow you to take pre-tax funds from every paycheck into an account managed by your company (or your company’s vendor), that you can remove on a tax free basis to pay for uncovered medical bills.

This has been a particularly useful program in my family as I have two children with learning disabilities as well as chronic physical conditions (one with scoliosis the other with JRA). At various times in their lives each has required constant medical care, drugs, physical therapy, etc. My daughter was in a back brace for four years which had to be changed every six-eight months because she had the nerve to grow (at least our insurance company said she had a lot of nerve for needing a new brace). My son at times needed special treatments for the constant pain.  You get the picture. Both, thank God, are doing very well.

While I had a Health Plan at work, when you add up the deductible, the treatments not allowed by the insurance company, the difference between the insurance company’s “reasonable fee” and reality, and the difference between the 80% of the fee they are supposed to cover and their version of the reasonable fee, every year my family was thousands of dollars in the medical hole. Without the help of the tax savings from the Flexible Spending Medical Accounts, we might have been up to our “assets” in debt scrambling to get our children the medical care they needed.

My family’s case is not unusual, nor is it extreme.  That’s why many are warning about the effects of Obamacare limiting flexible spending accounts on the nation’s poor and middle class.

Plan to Restrict Health Accounts Will Hurt the Disabled, Critics Warn

Families with special-needs children and people with chronic illnesses stand to lose hundreds, if not thousands, of dollars in tax benefits under proposed health care reform legislation, critics say, warning that a plan to cap the amount of money people can put into special “flexible spending” health accounts will have “cruel” and “unintended consequences.”

Families with special-needs children and people with chronic illnesses stand to lose hundreds, if not thousands, of dollars in tax benefits under proposed health care reform legislation, critics say, warning that a plan to cap the amount of money people can put into special “flexible spending” health accounts will have “cruel” and “unintended consequences.”

The Senate and House health care bills both include a revenue-raising provision that would cap at $2,500 the amount of money workers can put into flexible spending accounts. The accounts, used by millions, allow workers to store pre-tax dollars to cover out-of-pocket health care expenses during the year.

Many employers set a cap on contributions at about $5,000, according to Save Flexible Spending Plans, a group formed by benefits providers over the summer to lobby against the changes. Federal government workers are subject to a $5,000 limit, and most state governments impose a $3,000-$6,000 cap. But legally there is currently no cap across the board.

The change is projected to bring in about $15 billion over the next decade by limiting the pre-tax dollar savings, but critics say it could have devastating effects on families that rely on flexibile spending accounts to pay for health care expenses that are not covered by their insurance policies.

“It’s really become kind of a revenue grab rather than good sound health policy,” said Jody Dietel, chief compliance officer for WageWorks, a company that helps administer the accounts. She is also executive director of Save Flexible Spending Plans.

Dietel said her group has succeeded in convincing Congress not to eliminate the accounts altogether, an idea that was floated, but is still pushing to raise the cap to $5,000. The group also wants the Senate bill to make sure the cap is adjusted for inflation.

Dietel’s group estimates that about 35 million people use the flex accounts. She said the average deposit is under $1,500 annually, so most people — who use the money for copays and other small-dollar items — would not be terribly inconvenienced by a $2,500 cap.

But she said the change would be significant for those who routinely rack up out-of-pocket expenses due to chronic illnesses or special-needs children.

Policy groups estimate that people with chronic illnesses face more than $4,000 annually in out-of-pocket expenses. Flex account money can go toward that.

But the accounts have come under fire for contributing to wasteful health care spending — something the health care reform effort is trying to curb. Because the money must be spent in a calendar year, those looking to drain their accounts may dump them on unnecessary medical expenses at the last minute.

The Center on Budget and Policy Priorities suggested eliminating the accounts altogether when the health care reform debate was kicking into high gear over the summer.

“FSAs encourage the overconsumption of health care, which runs directly counter to a critical goal of health care reform,” the group said in a study, arguing that other health care reform provisions that limit out-of-pocket expenses would make FSAs less important anyway.

Ryan Ellis, tax policy director at Americans for Tax Reform, said the real pain from the new policy would be felt among families with special-needs children, who are currently able to use the money to pay for education expenses.

“The No.1 group that would be affected by this are parents of special needs,” he said, citing the tuition costs at some specialized schools that climb well into the thousands.

“This is a classic case of unintended consequences,” Ellis said. “And they’re often fairly cruel … This is a clear case of that.”

The push for the cap came from the Senate Finance Committee, and the cap eventually made its way into both the full House and Senate bills. A representative for Senate Finance Committee Chairman Max Baucus, D-Mont., could not be reached for comment.

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