Peasants can’t afford healthcare? Let them start HSAs

That’s me in the photo in last week’s Newton Now, listening to Rep. Estes with my hand clenched over my mouth. There were times I had things I wanted to say that were not indoor-voice things.

One of those times was when Estes responded to a questioner concerned about people losing their health insurance if Estes and his party succeed in repealing Obamacare. His advice: they should open Health Savings Accounts instead. So, what’s an HSA? If you put some of your income in an HAS, you don’t have to pay income tax on it, but you can only use those savings for medical expenses. In effect, you’ll get a tax deduction on some of what you spend on medical care.

An HSA a good deal if you have a income that puts you in a high tax bracket and also gives you a surplus to sock away for a need that might be years away. Otherwise, it’s useless. Saving an amount adequate to cover care for a serious illness is impossible on most people’s incomes, and even if it were possible, it would be unwise to put money in an account that couldn’t be diverted to some other need. And without the high tax rate that goes with a big income, the tax deduction is not significant, so paying for health care through an HSA would be just about the same as paying cash. HSAs are a gift to people who already have good access to health care, and an insult to those who don’t.

When Marie Antoinette was advised that the peasants couldn’t afford bread, she is said to have replied, “then let them eat pastry.” She lived in privilege and lacked the wit to understand that her subjects didn’t. People tried to clue her in, but she wouldn’t listen.

H. David Goering

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