in Houston, Texas
Patients getting prescriptions for aspirin, diaper rash meds because of Obamacare tax rule for flex spending accounts
Wednesday, Mar 09, 2011, 10:02AM CST
By Mark Lisheron
diaper rash cream

I guess when folks said Congress passed the Patient Protection and Affordable Care Act without reading it they weren’t kidding.

Patients, however, have gotten around to at least part of it and have found in the fine print that to be able to claim a tax exemption for their flexible spending accounts under the new law, their doctors must prescribe their purchases. This includes prescriptions for things like aspirin, cough medicine and diaper rash reliever, according to a front-page story in the Wall Street Journal

This is just one of the unintended consequences of the 1,000-page bill, the story says. Insurance companies reacting to a provision in the law forbidding them from denying coverage to children with pre-existing health conditions have stopped selling children’s policies altogether.

High premiums have stunted enrollment for high-risk patients who, experts thought, would bleed new insurance pools dry.

And the part of the law encouraging collaboration by health care providers to centralize patient care is running afoul of federal anti-trust regulators.

But for the 33 million Americans covered with tax-free, payroll-deducted flexible-spending accounts who must now make doctor visits before making what used to be routine purchases, this might be the most irksome consequence.

Doctors are now obliged to schedule visits and are responsible for a blizzard of prescription paperwork. Pharmacists are now obliged to type out and slap prescription labels on those jumbo-size bottles of ibuprofen.

How much of a burden might the new law be? Sales of over-the-counter medicines amounted to about $17 billion in 2010, excluding sales at Wal-Mart Stores Inc., according to Nielsen Co.

Contact Mark Lisheron at 512-299-2318 or

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Photo of diaper rash cream by flickr user are you my rik?, used via a Creative Commons license.
kevin whited
Thursday, 03/10/2011 - 06:28AM

** I guess when folks said Congress passed the Patient Protection and Affordable Care Act without reading it they weren’t kidding. **

I don't know why the WSJ treated this as unexpected or mysterious. It was neither.

This provision -- along with the onerous 1099 provision -- was included specifically for budget-scoring purposes: to make Obamacare look less expensive to the CBO.

To act as if it's some newly discovered mystery just isn't true to the facts. The WSJ is usually better than that.

For hardcore liberals, this provision had an added (hardly accidental) bonus -- chipping away at the market-oriented choice provided by Health Savings Accounts.

I believe Sen. Hutchison has proposed repealing this provision. If Texas Watchdog is going to insist on covering these national stories, tracking down the Texas angle might be a useful value add.

Lee Ann O'Neal
Thursday, 03/10/2011 - 10:23AM

Kevin, thanks for your comments and for reading. We hope in the coming months to offer a mix of health care stories more heavily focused on Texas. In the meantime, I did want to note for readers some stories we have published on health care this year that have a stronger Texas angle:

"Control of Texas’ health care system would revert to state under proposal from Rep. Lois Kolkhorst challenging Obamacare,"

"Policy group estimates health care reform will add $31 billion to Medicaid growth in Texas in a decade, bankrupting the Lone Star State"

"TX GOP lawmakers push for free-market health care reforms; federal rules place a straightjacket on changes"

Lee Ann O'Neal, Texas Watchdog

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