Republican pitches health savings accounts ‘on steroids’ that Americans could use to buy insurance — and steak

Amid the current Obamacare fight plaguing Congress, Rep. Eric Burlison, R-Mo., envisions a new kind of program that could help users purchase health insurance — and steak — similar to health savings accounts (HSAs).

“This new product would basically be a super HSA on steroids connected to a cafeteria plan that’s connected to charitable donations,” Burlison said.

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“Imagine, instead of getting your insurance through your employer, you go out and create your own account. We’ll call it a MAHA account, OK? And in that account, your employer would then deposit the money that they would normally pay to subsidize your premium,” Burlison said, referring to the Make America Healthy Again slogan used by the health-focused wing of the GOP.

Burlison’s proposal, which follows calls from President Donald Trump to reroute federal dollars for health insurance assistance straight to policyholders, would require a complete overhaul of how HSAs currently work. His proposal is also emblematic of efforts to eliminate current policy restrictions Republicans believe limit consumer choice and flexibility when it comes to healthcare.

Under their current framework, HSAs provide users with a tax-free account that can be set up with a bank or insurance company. 

“An HSA is a tax-exempt trust or custodial account you set up with a qualified HSA trustee to pay or reimburse certain medical expenses you incur,” the IRS states.

Every year, the IRS puts out a list of expenses HSA holders can use their accounts for. These can include anything from massage therapy guns to Warby Parker glasses. 

The list currently excludes health insurance.

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Burlison believes that by eliminating that restriction, his new accounts could help users make more careful decisions about their policies and give users a way to find alternatives to plans offered under the Affordable Care Act (ACA), also known as Obamacare.

“From that account, then you can pick any insurance product you want to buy. So, if you want to buy a state-sponsored plan, if you want to buy an ACA plan – I wouldn’t buy an ACA plan because there’s so many other better products out there,” Burlison said.

But in additional to healthcare, he believes the accounts’ restrictions should be used to incentivize better health-centered decisions through the accounts’ tax-exempt status.

“We want to encourage people to be healthy by letting them purchase healthy food; protein, produce,” Burlison said.

“Imagine you take your card, you go to the grocery store, and you know that the money that you put in that card was pre-tax money, and now you can go and buy steak or go buy chicken, go buy lettuce, whatever you want — as long as it’s unprocessed, healthy food. We’re encouraging people to be healthy and to eat healthy.”

Burlison noted that what he’s envisioning goes well beyond the current structure of HSAs and would likely require the creation of a completely new kind of account.

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“At the end of the day, this is such a new concept that I think it’s probably best to just leave HSAs intact and create this new product,” Burlison said.

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Burlison’s idea on HSAs is just one of many ideas Republicans have floated as an increasing number of lawmakers have wanted to address rising healthcare costs while also balancing questions about government involvement in subsidizing those costs.