The HSA Option

 

Benefits of the HSA Option

The Health Savings Account (HSA) option will improve the welfare of lower-income Americans by offering them more control over their health care. An HSA can be used to help Americans pay out-of-network costs and expenses like vision, dental, and hearing care.

An HSA can grow year after year to help enrollees prepare for health care expenses later in life. The HSA option will improve competition and lower costs market wide.

Key Components of the HSA Option

• Enrollees eligible for the CSR program will have the option to enroll in an HSA-qualified plan that offers an HSA contribution.
• Insurers offering exchange plans will be required to offer a plan with an HSA option and an associated contribution for each of the actuarially equivalent plans required by the CSR program.
• The insurer will make a monthly HSA deposit to the enrollee’s account.
• The enrollee may access the HSA only with a bank-issued debit card that ensures the funds are used only for qualified medical expenses. 

Summary and Recommendation

The HSA option would allow enrollees to have another way to access their subsidy for an exchange plan. Many enrollees with incomes below 200 percent of the federal poverty level would have access to thousands of dollars in their HSAs each year if they selected the HSA option. This would allow enrollees much greater control over how to use the funds to best meet their preferences and needs.

Congress should combine an HSA option with a CSR appropriation and a prohibition on silver loading. Based on past Congressional Budget Office estimates, this would likely expand coverage and reduce deficits. 

https://paragoninstitute.org/the-hsa-option/

Today's extraordinary New York Times piece on cannabis and psychosis

 I cannot stop thinking about sea change represented by the New York Times’s article today about the mental health dangers of cannabis.

In January 2019, Simon & Schuster published Tell Your Children, my book arguing cannabis use causes psychotic episodes and is likely a significant contributor to schizophrenia (and thus to violence, because untreated psychosis drives violence).

Two three-word sentences summarize the book’s thesis: Cannabis causes psychosis. Psychosis causes violence.

This simple statement stirred a furious media response - not just to the second sentence, but to the first, and not just from cannabis advocates but from nearly the entire non-conservative media.

The Washington Post published an op-ed calling the book “the return of ‘reefer madness.’” And another that criticized it for promoting “myths about marijuana.” And still another that said it was “ramping up the alarmism.” (That particularly risible piece was headlined “I smoked weed with my son. We’re closer now.” Sure you are. You should invest a couple hundred bucks in an eight-ball and try a few bumps with him, you’ll be thick as thieves.)

Again, those three pieces ran in The Washington Post - not openly left-leaning outlets like Rolling Stone or Vox. Reporters at those places engaged in a semi-coordinated campaign to smear the book - and me.

At Vox, German Lopez - a drug apologist who now works for the Times - wrote an endless screed, complete with charts, that claimed to explain “What Alex Berenson’s new book gets wrong about marijuana, psychosis, and violence.”

(Those were the days:)

—

Want to know what Tell Your Children gets wrong about cannabis, psychosis, and violence?

Nothing.

In the years since the book has come out, the scientific and epidemiologic evidence has only become stronger.

But the evidence was powerful even before I wrote Tell Your Children - which is why I could write it with such confidence. In fact, what was interesting even at the time was that the people who hated the book were unable to find factual errors in it (aside from a couple of what were essentially typos). Thus they attacked it on the now familiar grounds that it was filled with “misinformation” - that is, information they did not like.

No, the science hasn’t changed.

What has changed, I suspect, is that more and more parents are seeing what high doses of THC can do to their teenage (and in some cases adult) children, and sometimes in an astonishingly short time:

Elysse was 14 when she first started vaping cannabis… After the second or third try, she was hooked. “It was insane. Insane euphoria,” said Elysse, now 18…

But the euphoria eventually morphed into something more disturbing. Sometimes the marijuana would make Elysse feel more anxious, or sad. Another time she passed out in the shower, only to wake up half an hour later… Starting in 2020 she began having mysterious bouts of illness where she would throw up over and over… a gastroenterologist diagnosed her with cannabinoid hyperemesis syndrome, a condition that causes recurrent vomiting in heavy marijuana users.

This woeful tale comes not from a Drug Enforcement Administration pamphlet but from The New York Times. Which went on to write:

In addition to uncontrollable vomiting and addiction, adolescents who frequently use high doses of cannabis may also experience psychosis that could possibly lead to lifelong psychiatric disorder, an increased likelihood of developing depression and suicidal ideation, changes in brain anatomy and connectivity and poor memory.

Too many parents have seen the truth. Nice woke parents who let their children use cannabis - “We’re closer now” - and now see those kids’s lives going, well, up in smoke.

The crime issue is more complex, but suffice it to say that the years following recreational legalization have not been happy ones for public - or traffic - safety, and cases revealing a striking connection between cannabis and violent crime keep popping up. Cannabis causes psychosis. Psychosis causes violence.

When I wrote Tell Your Children, I imagined full national legalization of cannabis was all-but-certain. I’m not so sure. The high potency version of the drug is just too obviously harmful, and a lot of parents now feel suckered.

The green wave may finally have peaked and be beginning to recede. Only time will tell how much damage it has done.

Meanwhile, please, Tell Your Children.

Alex Berenson is a former New York Times reporter and the author of 13 novels, three non-fiction books, and the Unreported Truths booklets. His newest book, PANDEMIA, on the coronavirus and our response to it, was published on Nov. 30.

https://alexberenson.substack.com/p/todays-extraordinary-new-york-times

10 arrested in Oregon during ‘Night of Rage’ in response to abortion ruling

 Authorities in Oregon arrested 10 protesters who were part of a large crowd supporting abortion rights after the demonstration turned violent.

Police in the city of Eugene, a city about an hour and a half away from Portland, said in a news release that protesters clashed with officers and threw smoke bombs during the demonstration at a pregnancy center on Friday night.

Nine people were charged with disorderly conduct including one person who was additionally charged with escape in the third degree and resisting arrest. One person was charged with harassment.

Officials said a large crowd gathered at the Dove Medical Center around 9:21 p.m. on Friday night as part of the “Night of Rage” protests against the Supreme Court overturning Roe v. Wade, which had enshrined abortion as a constitutional right, earlier in the day.

Protesters arrived wearing black clothing as well as masks and hoods, according to the Eugene Police Department. The crowd grew to 75 people and some protesters eventually began picking up rocks and putting on gas masks, officials added.

Police reportedly tried to disperse the crowd after protesters began hurling smoke bombs and filled water bottles at officers.

Officials said officers began making arrests but members of the crowd resisted, some of them violently. Officers began shooting inert pepperballs at the feet of the protesters, the department added, which eventually broke up the demonstration.

Several protests swept the nation after the Supreme Court’s conservative majority voted 5-4 on Friday to overturn Roe v. Wade, allowing individual states to ban or limit abortions.

In Arizona, thousands of protesters converged on the state capitol building on Friday night, forcing some lawmakers to huddle in the basement, according to The Associated Press.

https://thehill.com/policy/healthcare/3537322-10-arrested-in-oregon-during-night-of-rage-in-response-to-abortion-ruling/

WHO Says Monkeypox Is Not Yet a Health Emergency

 Monkeypox is not yet a global health emergency, the World Health Organization (WHO) ruled on Saturday, although WHO Director-General Tedros Adhanom Ghebreyesus said he was deeply concerned about the outbreak.

"I am deeply concerned about the monkeypox outbreak, this is clearly an evolving health threat that my colleagues and I in the WHO Secretariat are following extremely closely," Tedros said in a statement.

WHO said in a separate statement that although there were some differing views within the committee, they ultimately agreed by consensus that at this stage the outbreak is not a Public Health Emergency of International Concern (PHEIC).

The "global emergency" label currently only applies to the coronavirus pandemic and ongoing efforts to eradicate polio, and the U.N. agency has stepped back from applying it to the monkeypox outbreak after advice from a meeting of international experts.

There have been more than 3,200 confirmed cases of monkeypox and one death reported in the last six weeks from 48 countries where it does not usually spread, according to WHO.

So far this year almost 1,500 cases and 70 deaths in central Africa, where the disease is more common, have also been reported, chiefly in the Democratic Republic of Congo.

Monkeypox, a viral illness causing flu-like symptoms and skin lesions, has been spreading largely in men who have sex with men outside the countries where it is endemic.

There are vaccines and treatments available for monkeypox, although they are in limited supply.

Some global health experts said WHO may be have been hesitant to make a declaration because its January 2020 declaration that the new coronavirus represented a public health emergency was largely met with skepticism around the world.

But others said the outbreak met the criteria to be called an emergency.

Gregg Gonsalves, an associate professor of epidemiology at Yale University who advised the committee but who is not a member of WHO, told Reuters by email on Saturday that he thought the decision was "misguided".

"It met all the criteria but they decided to punt on this momentous decision," he said.

https://www.usnews.com/news/top-news/articles/2022-06-25/who-says-monkeypox-is-not-yet-a-health-emergency

Legal clashes await companies covering workers’ abortion costs

 A growing number of large U.S. companies have said they will cover travel costs for employees who must leave their home states to get abortions, but these new policies could expose businesses to lawsuits and even potential criminal liability, legal experts said.

Amazon.com Inc., Apple Inc., Lyft Inc., Microsoft Corp. and JPMorgan Chase & Co. were among companies that announced plans to provide those benefits through their health insurance plans in anticipation of Friday’s U.S. Supreme Court decision overturning the landmark 1973 Roe v. Wade ruling that had legalized abortion nationwide.

Within an hour of the decision being released, Conde Nast chief executive Roger Lynch sent a memo to staff announcing a travel reimbursement policy and calling the court’s ruling “a crushing blow to reproductive rights.” Walt Disney Co. unveiled a similar policy on Friday, telling employees that it recognizes the impact of the abortion ruling but remains committed to providing comprehensive access to quality health care, according to a spokesman.

Companies including health insurer Cigna Corp., Paypal Holdings, Alaska Airlines Inc. and Dick’s Sporting Goods Inc. also announced reimbursement policies on Friday.

Abortion restrictions that were already on the books in 13 states went into effect as a result of Friday’s ruling and at least a dozen other Republican-led states are expected to ban abortion.

The court’s decision, driven by its conservative majority, upheld a Mississippi law that bans abortion after 15 weeks. Meanwhile, some Democratic-led states are moving to bolster access to abortion.

Companies will have to navigate that patchwork of state laws and are likely to draw the ire of anti-abortion groups and Republican-led states if they adopt policies supportive of employees having abortions.

State lawmakers in Texas have already threatened Citigroup Inc. and Lyft, which had earlier announced travel reimbursement policies, with legal repercussions. A group of Republican lawmakers in a letter last month to Lyft chief executive Logan Green said Texas “will take swift and decisive action” if the ride-hailing company implements the policy.

The legislators also outlined a series of abortion-related proposals, including a bill that would bar companies from doing business in Texas if they pay for residents of the state to receive abortions elsewhere.

Lawsuits looming  

It is likely only a matter of time before companies face lawsuits from states or anti-abortion campaigners claiming that abortion-related payments violate state bans on facilitating or aiding and abetting abortions, according to Robin Fretwell Wilson, a law professor at the University of Illinois and expert on health care law.

“If you can sue me as a person for carrying your daughter across state lines, you can sue Amazon for paying for it,” Wilson said.

Amazon, Citigroup, Lyft, Conde Nast and several other companies that have announced reimbursement policies did not respond to requests for comment.

For many large companies that fund their own health plans, the federal law regulating employee benefits will provide crucial cover in civil lawsuits over their reimbursement policies, several lawyers and other legal experts said.

The Employee Retirement Income Security Act of 1974  prohibits states from adopting requirements that “relate to” employer-sponsored health plans. Courts have for decades interpreted that language to bar state laws that dictate what health plans can and cannot cover.

ERISA regulates benefit plans that are funded directly by employers, known as self-insured plans. In 2021, 64% of U.S. workers with employer-sponsored health insurance were covered by self-insured plans, according to the Kaiser Family Foundation.

Any company sued over an abortion travel reimbursement requirement will likely cite ERISA as a defense, according to Katy Johnson, senior counsel for health policy at the American Benefits Council, a trade group. And that will be a strong argument, she said, particularly for businesses with general reimbursement policies for necessary medical-related travel rather than those that single out abortion.

Johnson said reimbursements for other kinds of medical-related travel, such as visits to hospitals designated “centers of excellence,” are already common even though policies related to abortion are still relatively rare.

“While this may seem new, it’s not in the general sense and the law already tells us how to handle it,” Johnson said.

Limits

The argument has its limits. Fully-insured health plans, in which employers purchase coverage through a commercial insurer, cover about one-third of workers with insurance and are regulated by state law and not ERISA.

Most small and medium-sized U.S. businesses have fully-insured plans and could not argue that ERISA prevents states from limiting abortion coverage.

And, ERISA cannot prevent states from enforcing criminal laws, such as those in several states that make it a crime to aid and abet abortion, so employers who adopt reimbursement policies are vulnerable to criminal charges from state and local prosecutors.

But since most criminal abortion laws have not been enforced in decades, since Roe was decided, it is unclear whether officials would attempt to prosecute companies, according to Danita Merlau, a Chicago-based lawyer who advises companies on benefits issues.

https://www.stltoday.com/news/national/govt-and-politics/legal-clashes-await-companies-covering-workers-abortion-costs/article_9421af8d-9506-5ebb-a18e-817f5f528b26.html