Top Of My Head

Thoughts on everything from Politics to Video Games

Date: March 6, 2009

A Reply

Below is the response email I received from Congressman Paul Ryan.  In fact, Paul Ryan ALWAYS responds and even when I disagree with his response, at least he responds in a timely manner.  I’m sure once he receives the hard copy of the email, I’ll get a nice hard copy letter back from him.  I love how he (or his staff) always adds a link or a phone number to gather more information.

If I’m understanding his response, Ryan is trying to get a bill through that would offer much of what I thought the program should do.  What I don’t understand is if there’s a solution all ready out there, why isn’t someone acting on it?  I wish he had added the names of the other Congressmen who support the bill.  Anyway, I think I’ll ask for a copy of the bill and when I receive it (I think I can find it on the Congress Website, but I’m not sure), I’ll post it here.  That way, if you agree with it, you can pester you’re own Representative to get this out for a real vote.

I don’t think the picture of his letterhead will appear here, but trust me, this came from his office.

Dear Julie:

            Thank you for contacting me to express your interest in the health savings accounts created in the Medicare Prescription Drug, Improvement, and Modernization Act, H.R.1.  This legislation was passed recently in the Congress and was signed into law on Monday December 8th, 2003.  I appreciate your taking the time to contact me on this important issue. 

            H.R. 1 makes a very important contribution to modernizing health care with the creation of health savings accounts (HSAs).  HSAs are a tool for individuals and employers to save and pay for their health care costs, including Medicare premiums and co-pays.  I co-authored the HSA provision passed in the Medicare bill and worked hard to see that the provision was included in the law because I believe they are very important to the future of health care.  The purpose of HSAs is to allow individuals, as opposed to insurance companies, to control their own health care dollars and manage their own health care needs.

 HSAs build off of the more-restrictive Archer Medical Savings Accounts (MSAs) that are already available to certain qualifying individuals.  HSAs provide all Americans the opportunity to save and pay for their health care costs tax-free.  An HSA participant carries a high deductible insurance plan that is used primarily for serious illnesses, while routine medical costs, even Medicare costs, are paid for out of the individual’s HSA.  Individuals, employers, or even family members can contribute money to an HSA.  And, HSAs are portable, from job-to-job and into retirement.  Contributions are tax deductible for both employers and employees, and all account balances can be carried over each year.  Also, account growth and health expenditures are tax-free as well. 

For your reference, here’s a quick summary of HSAs:

A qualifying high deductible insurance has a minimum deductible of $1000 for an individual, and $2000 for a family.  Out-of-pocket costs must not exceed $5000 for an individual or $10,000 for a family.

Savings are portable, from job-to-job and into retirement.

Contributions can be made by individuals, employers and family members.

Annual tax-deductible contributions may be made up to the lesser of 100% of the deductible or $2,600 for singles and $5,150 for families.

Individuals age 55 and older can make catch-up contributions of up to $1,000. 

Savings can be used for qualified medical expenses, including retiree health insurance premiums, Medicare expenses, prescription drugs, long-term care services and insurance. 

HSAs give people control over their own health care dollars, encouraging them to make good consumer decisions and helping to hold down health care costs.

 HSAs became available in the market from insurance companies on January 1, 2004.  Some insurance companies are already offering HSAs while many others will be coming out with their products throughout the year. 

 In order to expand access to HSAs, I introduced, with several of my colleagues, H.R. 1872, the Health Coverage for the Uninsured Act, on April 27, 2005.   This bill tries to hone in on the problem of the uninsured where we can have the most impact: individuals who do not receive health care through their employer and small businesses that cannot afford to offer health care coverage.  The legislation encourages individuals to purchase a high deductible health plan (HDHP), and contribute to an HSA, by allowing for an above-the-line deduction of the health care premium.  Also, small businesses that offer high-deductible plans would receive a tax credit if they contribute to an employee’s Health Savings Account.  Finally, the legislation would assist low-income individuals in purchasing health insurance by providing a tax credit for the purchase of health insurance. 

 Lastly, you may find further information on HSAs on the Department of Treasury’s web site:  If you have any further questions about HSAs, please feel free to contact me again.

            Thank you again for contacting me on this issue.  If I can be of further assistance to you regarding this or any other matter, please do not hesitate to contact me.  I am always happy to respond and be of service to you.


Paul Ryan
Serving Wisconsin’s 1st District

Healthcare Reform

Below is a copy of a letter I sent to President Obama.  I sent a similar one to Senators Kohl and Feingold and one to Congressman Paul Ryan.  I wrote a similar blog post with a little of this outlined, I define it a little better in the letter.  I know that this isn’t the full solution, but it is a start.  If you agree, feel free to send a copy to your Congressman and Senators.  If you don’t agree, feel free to send me an email with your own idea and I’ll post it here.  We need to start working together to solve the crisis in our Nation’s healthcare.  Further, we cannot afford to seek short-term solutions.  With the baby boomers on the verge of retiring, our Nation’s healthcare system will be taxed like it has never been taxed before.  We need to start looking to the future.  I don’t want this plan to replace employer provided healthcare — it should enhance it.

God Bless

March 6, 2009

Barack Obama
President of the United States of America
1600 Pennsylvania Avenue NW
Washington, DC 20500

Dear President Obama:

Recently, I torn the cartilage in my knee and required surgery to repair it.  The total cost of the surgery was roughly $3300.  I am a very lucky American in that not only did I have health insurance to cover the majority of my bill, but also I have short-term disability to continue my paychecks rolling in during the two weeks of recovery.  Normally, I would not believe that my knee surgery would warrant the attention of the President, but the idea that came to me because of it does.

I know that today you are holding a healthcare forum to come up with an idea to solve our nation’s very real healthcare issues.  Unfortunately, I am not going to be there to tell you my idea, so I hope this letter doesn’t reach you too late to do any good.  I believe very strongly that the answer to our healthcare problems all ready exists in Health Savings Accounts.

Health Savings Accounts allow people to save for their own healthcare and they do not require anything but the minimum in insurance coverage.  Health Savings Accounts (HSA) allow individuals and families to pay for their own healthcare.  The advantages are lower premiums for employers.  In addition, HSA is not a use it or lose it plan.  You can keep the money from year to year.

There are a couple of downfalls to the current HSA legislation. 

First, there are maximum pre-tax amounts that seem a little to low for this to work.  The current limits are $3,000 for single coverage and $5,950 for a family.  I believe the limits should be raised to $7,000 for single coverage and $14,000 for a family.  My reasoning is that the more money people save, the more money there will be left once they retire, which would mean less money Medicare will pay in the future.

Second, the individual will have to pay the high price for their healthcare.  Remember the $3300 I mentioned earlier for my knee surgery?  My insurance company had that amount dropped to around $1000.  They paid 90%, which left me a $100 bill for a $3300 surgery.  Someone with an HSA would probably not have that option.  My solution to this is the same thing insurance companies have been doing.  1. We have out of network doctors and in network doctors.  The in network doctors would pay a fee much as they do now to insurance companies.  These fees would be used to pay for the administration of the whole process.  2. The government would use the same process of determining rates that insurance companies use now.  They average out the rates charged by doctors in certain areas and determine the average.  Then, the fee for that service is set. 

Now, I’d like to add that this isn’t meant to replace the current health insurance.  This could be a lower cost plan for companies that cannot afford the high insurance premiums.  I believe that companies must receive some tax benefits for carrying health insurance and I think we should offer a chance to help companies match their employees’ contributions. 

I sincerely hope, President Obama, that you are shown this letter.  I would be willing to discuss this with you or any member of your staff.  Your election has made me believe more than any other time in my adult life that one person can make a difference and change the world.  Please know that I always keep you and yours in my prayers.

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