Removing Affordable Care Act provision restricting use of FSAs for OTCs would save taxpayers money

Sen. Mike Johanns, R-Neb., Rep. Erik Paulsen, R-Minn., introduce legislation to repeal restrictions

A representative and a senator, both Republicans, recently introduced legislation that would repeal restrictions on health savings accounts and flexible spending accounts in the Patient Protection and Affordable Care Act of 2010 that prohibit the use of HSA and FSA account dollars for the purchase of over-the-counter drugs without a prescription.

One of the sponsors of the Family Health Care Flexibility Act, Sen. Mike Johanns of Nebraska, called the restrictions "government overreach and interference." But they're more than that: They're simply wasteful. The whole point of healthcare reform is to expand access to health care while reducing cost, and requiring an expensive and time-consuming doctor visit to get a prescription for an OTC drug fails at both goals.

At a hearing last year, when similar legislation was introduced, Consumer Healthcare Products Association president and CEO Scott Melville said in testimony that the restrictions mean FSA participants are faced with three choices: Make a doctor's appointment to get a prescription in order to get reimbursement; forgo 10% to 35% in savings by buying the medication without reimbursement; or forgo treatment altogether.

But Melville's testimony also included a bigger tidbit: figures from a study by Booz & Co. indicating that OTC drugs save the country's healthcare system $102 billion annually, with about three-quarters of that coming from reduced doctor visits.

With more than 30 million Americans expected to have healthcare coverage when the ACA takes full effect next year, the country will already face a major shortage of primary care providers. That's what's driving moves at state and federal levels to have pharmacists and nurse practitioners classified as healthcare providers.

But they alone can't reduce the burden; part of that will need to come from patients being able to treat minor ailments themselves. With the Booz & Co. study reporting that 240 million people treat illnesses with OTC medicines every year, the last thing the country needs is for the 9.8 million patients whom Nielsen estimates to have used the FSA program to buy OTC drugs before the ACA provision took effect in January 2011 to have to see a doctor for a runny nose.

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