30 Comments - Brennan - Friday, Mar 5, 10 @ 10:24 am: =Due to the rejection of these plans by government unions, the average use of HSAs in the public sector across the country is just 2%.= They work, but good luck getting them in Illinois at the same time unions are trying to kill them in Washington. - Dnstateanon - Friday, Mar 5, 10 @ 10:28 am: ==The top House Republican leader Thursday shoved the possibility of an income-tax increase this spring further into the legislative deep freeze,== Why is it up to Cross for there to be a tax increase there are more then enough Democrats to have a tax increase? The Democrats decided to overspend revenue when they didn’t have it. Quinn chose’s not to fund the budget and therefore under fund Schools and Universities cause the layoffs all over the state. Democrats need to fix this problem and quit blaming republicans. - Secret Square - Friday, Mar 5, 10 @ 10:30 am: Current state employees do have the option of Flexible Spending Accounts, which are similar to HSAs, except that funds cannot be carried over from one year to the next. The funds come from pre-tax payroll deduction (similar to health and life insurance premiums). - dave - Friday, Mar 5, 10 @ 10:33 am: Rich - thanks for bringing up the inflation argument. For IPI/Cross to pretend that the population growth alone is what should impact spending is more than a bit disingenuous. - Rob N - Friday, Mar 5, 10 @ 10:34 am: Rich says, “I don’t know much about health savings accounts, but it appears to be working across our eastern border.” I’d dig deeper before falling for the former Bush Administration official’s spin on HSAs. Does Indiana have a law requiring hospitals, labs, doctors, etc. to publicly list their pricing schedules? If not, how on earth are you supposed to “become more cost-conscious and careful about overpayment or overutilization”? Going to the doctor ain’t like comparing dollar value menus at Burger King vs McDonalds. Can you imagine? “Excuse me, hospital X, I’ve broken my leg and think I’m bleeding internally. How much do you charge for x-rays and surgeries? … OK. I’ll get back to you after I check with the next few hospitals on my list. Thanks.” Pharmacies are starting to get a bit better in this regard. You can occasionally comparison shop your Rx needs between Walgreens, CVS, Osco, Target, etc. But if Illinois govt wants to go the HSA route then fine. But first they ought to follow the lead of other states and put some laws regarding truth in pricing so we know how much medical procedures cost. (And yes, I speak from experience.) - MOON - Friday, Mar 5, 10 @ 10:37 am: DNSTATEANON Just because the Dems have enough votes does not mean all Dems would vote for the increase. Furthermore, part of our States problem is the current economy(recession). If the State needs additional revenue then it is the responsibilty of both Dems and the Gop to address the issue! - Secret Square - Friday, Mar 5, 10 @ 10:40 am: Having an HSA has been very helpful for me. It comes in handy for things like doctor visit co-pays and deductibles for dental work (which I have had a lot of in the last few years). It’s meant to supplement (not replace) your insurance. I just wish the funds could carry over from year to year. - VanillaMan - Friday, Mar 5, 10 @ 10:40 am: The reason Cross did this is political. Brady is tanking so the GOP is desperate. This has to be the year doomsday arrives, and instead of putting it off, the few GOP legislators would rather see their opposition sitting on the hot seat this year so that the crisis will create an electoral opportunity for the GOP. This doesn’t mean that Doomsday will arrive, because of the GOP - it means it arrives this year, instead of next year. The GOP has nothing to lose in a political year they were supposed to return to power, but are failing with Brady. If Brady had a better chance, then there would be a better chance for a compromise to keep Doomsday from arriving this year. This is a case where the minority party is so desperate in an election year, they will not compromise with the Party In Power to save their political hides. The GOP simply has nothing to lose because it is such a powerless fringe player. Consequentially there is no benefit to compromising with the Illinois Democrats. When an economic pie shrinks, and the minority political regions haven’t gotten a crumb since 2005, it doesn’t hurt them to threaten to throw the entire pie out the window. - VanillaMan - Friday, Mar 5, 10 @ 10:48 am: Regarding Governor Mitch Daniels and his successes as Indiana governor - The public employees love the new medical saving accounts. It had always been an option, so when they sign up and stay with it - they are voting with their own health. This plan has been in place for more than a few years and it has been a monstrous success. Considering where we are economically in Illinois, it is ridiculous for us to point and complain about a real world solution that has been as successful as Indiana’s has been. It doesn’t matter if their governor worked for two years, or twenty years, with the Democrat’s hated phantom, (Bush!). What matters is that this works. And works well. Go ahead and use Walmart, Burger King, McDonalds, or Target as insults. Those global businesses are booming. If we can learn from what makes them so successful, and harness that knowledge and compromise within the conditions we need within government - we all win, regardless of political party. Don’t insult success when you are as poor as a church mouse. - irish - Friday, Mar 5, 10 @ 10:51 am: These plans success or failure also depends heavily on who is chosen as the Administrator. In Indiana the Administrator was probably the lowest bidder with a good reputation. In Illinois it will be whoever is related to whoever picks the Administrator. Illinois currently has a Flex Spending plan where employees can set aside pre tax dollars to cover portions of bills that aren’t covered by insurances. I know several people who enrolled in these plans and they got out of them as soon as they could. They were a nightmare. The Administrator was nonresponsive to issues and questions and getting one bill straightened out took numerous phone calls and letters. It is also hard to pay your portion of the bill when the State Insurance is running a six to eighth month lag on their portion. If Illinois ever went to this plan a separate committe of clergymen with a large safe would have to be in charge just to keep the GA and Governor’s hands out of the employee’s money. I can see them doing the same thing to this fund as they have to the money the employees have paid into the pension fund. - Secret Square - Friday, Mar 5, 10 @ 10:59 am: “The Administrator was nonresponsive to issues and questions and getting one bill straightened out took numerous phone calls and letters. It is also hard to pay your portion of the bill when the State Insurance is running a six to eighth month lag on their portion.” Other people’s experiences may be different, but I can honestly say I have NEVER had a problem with the administrator of this plan (a firm located in Florida). My reimbursement requests have always been handled promptly and without any questions. I can file a request by fax or online and get the money by direct deposit within a couple of days. I do agree, though, that it’s hard to know what your portion of the bill will be when insurance takes 6 months or more to pay up. I currently have a large oustanding balance with a dental provider and would like to use some of my FSA money to help pay it off; but since I don’t know for certain how much my final share is going to be, I can’t. - Mountain Man - Friday, Mar 5, 10 @ 11:04 am: Secret Square, You are confusing HSAs with FSAs. HSA funds do carry over from year to year and are designed to replace standard medical insurance. FSAs are simply a pre-tax account with which you reimburse yourself for medical expenses….they supplement insurance. HSAs work fine if you are healthy and don’t have a lot of medical expenses. If, however, you have a chronic illness or a major medical expense, and they are not very good at all. They generally have a very high deductable ($5,000-10,000)coupled with a sky high maximum out of pocket limit ($50,000-75,000) at which point a catestrophic insurance plan kicks in. - irish - Friday, Mar 5, 10 @ 11:11 am: ==Mountain Man== We are not confusing them we are just stating that while Illinois does not have an HSA program they do have a FSA program, AND we are pointing out how, the FSA program, which is somewhat similar to a HSA program, has issues because it is an Illinois program. So just because it works in Indiana doesn’t mean it will work in Illinois. - M - Friday, Mar 5, 10 @ 11:16 am: So if Sen. Forby thinks that 18 is the magic age for everything (which obviously he does from his remarks on voting and joining the military) we can look forward to him introducing legislation soon to lower the drinking age to 18. - George - Friday, Mar 5, 10 @ 11:17 am: With regard to the Population growth…. I thought everyone was FLEEING Illinois? - wordslinger - Friday, Mar 5, 10 @ 11:20 am: The way I read the Indiana HSA, the worker is on the hook for $3,000 out of pocket per year up to $6,000 when full coverage kicks in. That’s probably a good deal for singles and younger workers. They might not spend the state amount every year, and the rollover is a nice incentive. The state has, initially at least, a lower fixed cost. For those who have or plan to have children, straight coverage is probably the best buy for the risk. - Anon Sequitor - Friday, Mar 5, 10 @ 11:23 am: Mountain Man, you are either a very poor shopper if that is the best HSA deal you can get, or perhaps you are a very high risk. I have an individual HSA compatible health policy with a high deductible equal to my HSA max - I’m over 55. This plan, including my potential $3K HSA max, is half the cost of the COBRA plan from my former employer that I dropped. I also get discounted health services through the insurance carrier that reduce my out-of-pocket expenses. HSA’s are a very smart approach to holding down the cost of health care. If you don’t spend the money, you get to keep it, tax free. - Secret Square - Friday, Mar 5, 10 @ 11:25 am: I’m not confusing the two either; I know that an FSA is not the same as an HSA. I do think it would be nice if FSA funds could carry over from year to year, and I don’t see any reason why they shouldn’t. - Reformer - Friday, Mar 5, 10 @ 11:26 am: What Cross won’t do is specify exactly where he’d slash the budget by $13 billon to balance it. Neither will Brady. VanillaMan has an accurate analysis of why the minority would rather have the house of cards collapse than collaborate in shoring it up. - Anon Sequitor - Friday, Mar 5, 10 @ 11:27 am: Let me add, that even if you do spend the max HSA, insurance kicks in to cover the balance. When you compare this plan with the deductible requirements and copays common in most group plans, it makes a lot of economic sense. PS. I don’t work for an insurance company, I just like to save money and taxes. - Greg B. - Friday, Mar 5, 10 @ 11:59 am: Rob N makes a good point on the need for hospitals to post prices and it would be great if we had a consumer reports on quality of care as well. This can be done with the market solution — consumer reports is — than a govt. imposed solution. But I think the threat of regulating is acceptable compromise and would help with HSA’s. As far as the broken leg argument, Rob N makes a crucial error. If you have a $2,600 deductible on a HSA then broken leg would be covered by the catastrophic portion. The holder would be responsible for the first $2,600 and that’s it. I believe in IN, the deductible every year is put into the state employees account. I’m not sure, though. What they don’t spend they keep. Where it saves money is that people are asking questions and using less expensive but equally effective generic drugs for routine things such as HBP. An annual check-up, an antibiotic for an infection, stitches at the express clinic are the kinds of things you pay for out of pocket. Broken legs that require ER visits, x-rays, re-habilitiation and medical devices are the kinds of things catastrophic insurance is supposed to cover. Does there need to be more transparency in hospital pricing? Yes. Without transparent can HSA’s work? Yes. You just have to ask, “Are there alternatives that are less expensive?” I’ve done so. It works. Another point I’d make is that HSA’s aren’t the only solution. You still need comprehensive insurance, still need public insurance for the destitute. It’s expensive but you still need high risk pools — which Illinois does have. The fact that high numbers of IN employees want HSA’s are great. They also are taking a chunk of the uninsured problem off the table as they tend to be adopted by those w/out insurance. But they should one of many choices consumers have. - fredformeranon - Friday, Mar 5, 10 @ 12:42 pm: Is anyone here hopeful the budget mess will get fixed. Personally I don’t feel there is anybody in the state of Illinois today that has the courage to do what is appropriate to deal with the problem. Can someone finally say it. Oh, i guess I will We are ALL doomed!!!!!! - Special Assistant - Friday, Mar 5, 10 @ 1:16 pm: On the horse slaughter issue, they need to bring it back. When it was voted on, they did not “think” of the consequences of their actions. Some people must survive on the meat, even some in our culture, and it will help drive up the horse market. It tanked after the new law took affect and people were turning their sick and unwanted horses loose in parks and rural areas. Thank god they get their heads out of their #@# this time. - Elin - Friday, Mar 5, 10 @ 1:31 pm: I’ve had a Health Savings Account for three years and I love it. I wouldn’t go back to a regular PPO if it was offered to me. I used it to save up over time for laser eye surgery, which let me ditch eyeglasses. Because it rolls over year to year, I can use it to save for expenses later on in life. I can even will it to my kids! My HSA makes me a smarter health care consumer. I’ve shopped around between doctors for a service (e.g., skin cancer screening) to find the best price. All of the doctors had to be accepted into my insurance plan, so I felt confident on quality. The plan cost my employer less to offer, so it was a win on their end. They put some of that savings in to my HSA as an employer contribution. I then can add to this amount with tax-free payroll deductions. Why not at least offer an HSA option to state employees? A few will take it at first, but then as more people figure out what a great deal it can be, more will probably enroll. The state saves money. Win win. - lincolnlover - Friday, Mar 5, 10 @ 1:43 pm: I am understanding how the FSA would work? It sounds like the employee is on the hook for big bucks and the state is off the hook for any responsibility? - Secret Square - Friday, Mar 5, 10 @ 1:56 pm: Lincolnlover: Yes, with an FSA all the money comes out of your paycheck, before taxes. You decide each year (during the benefit choice period) how much you want taken out of each paycheck to put into the account. That amount times however many paychecks you get per year determines how much goes into the account. You have access to the entire balance from the first day of the plan year and don’t have to wait for the money to accumulate. Then you have 15 months — the “plan year” plus a 3 month “grace period” — to use up the funds for a given plan year. Whatever you don’t use by the end of the grace period is lost. The state does NOT match or add anything to your FSA. The funds can be used to cover expenses that your insurance does not cover, such as deductibles, co-pays, and charges for over the counter medicines. Because the funds don’t roll over, FSA users are advised to try to estimate as conservatively as possible what their out-of-pocket medical expenses will be each year. There is no incentive to deposit extra money, or to leave unclaimed funds in an FSA account. - RJW - Friday, Mar 5, 10 @ 2:00 pm: There is no way I would do an HSA with a family of 5 (including 3 younger children). I need to know more, but what happens with a catastrophic illness? My son had leukemia. If I understand the Indiana plan described above this would have cost me $8,000 (is that per year?). My co-pays were much smaller than that. The $2,750 is a completely inadequate amount of money for health care for a person. I didn’t know my son would get leukemia so the HSA is a big gamble in my opinion and it is not one I’m willing to take. Health care is a right (at least it should be) and people should not have to be placed in financial hardships because of it. If this is what the employer/employee relationship is coming to and employers are not willing to provide any benefits to employees anymore then maybe we should have let our economy collapse and started all over. - Dnstateanon - Friday, Mar 5, 10 @ 2:29 pm: MOON ===Just because the Dems have enough votes does not mean all Dems would vote for the increase. Furthermore, part of our States problem is the current economy(recession). If the State needs additional revenue then it is the responsibility of both Dems and the GOP to address the issue!=== WHY and it’s not just the economy it’s their spending and lack of creditable budget? That’s what being in the leadership means they have control take responsibility for your screw up. Madigan and Quinn spent the money; they can raise the taxes Madigan run’s the house so well he can get the votes he doesn’t want to lose the seats. - Quiet Sage - Friday, Mar 5, 10 @ 2:34 pm: The use by corporate America of HSAs is analogous to their conversion from defined benefit to defined contribution pension plans. Under the guise of more individual control, these plans actually bring about a reduction in the benefits of most workers. - ZC - Friday, Mar 5, 10 @ 8:05 pm: It sounds to me so far like HSAs would be popular with most workers because most workers are healthy most of the time. If you don’t get seriously sick, HSAs are a winner. I’d like to know more what happens with people who -do- get the catastrophic health care accident, in Indiana, before judging either way. Trying to keep an open mind here, to be sure, but saying HSAs are popular -could- be a bit like most Americans saying they’re happy with their health coverage - they’re happy in part because they haven’t had to use it yet for anything serious. Sorry, comments for this post are now closed.