House picks up on FSA debate, but will Supreme Court make it moot?


WHAT IT MEANS AND WHY IT'S IMPORTANT — This is one of the tweaks health reform needs to make it meaningful and to appropriately align all of the incentives in the right direction — and that's toward overall healthcare cost reduction. Because mandating a prescription in order that nonprescription medicines would be eligible expenses under either flexible spending accounts or health savings accounts just never made sense, intuitive or otherwise. That mandate doesn't serve to lower the cost of healthcare or improve access; it just creates an additional layer of cost and builds a barrier to savings.

(THE NEWS: House to consider repealing prescription mandate on OTCs purchased through FSAs. For the full story, click here.)

DSN wholeheartedly approves reinstating OTC reimbursements under FSAs and HSAs sans any restrictions. Fact is, if you really want to be cost-savings-oriented, the benefit should not only be reinstated but also expanded to include dietary supplements. But we may be a little ahead of the curve on that.

Unfortunately, even though it's been added to the docket, there is a question as to whether or not it will actually be debated on the House floor, at least until after June. The monkey wrench here is the Supreme Court deliberation over the entire Affordable Care Act. Any legislative movement to change the healthcare reform at this stage could all become moot after any Supreme Court decision.

And if the Supreme Court rules against the Affordable Care Act, that opens a whole new can of worms. Because what happens if the Supreme Court rules the Affordable Care Act unconstitutional and renounces the entire piece of legislation? Would all resort to what was the status quo before the legislation went into effect — meaning prescriptions would no longer be required for OTC reimbursement eligibility under FSAs/HSAs? And if that ruling comes in the middle of a plan year, will plan administrators be able to incorporate OTC reimbursements with no disruption to the patient? Or will the patients have to wait until the next plan year? How about disruption to the retailers? Would that necessitate some quick overhauls of their pharmacy point-of-sale systems so that nonprescription items would be recognized whenever an FSA debit card was swiped?

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