LINCOLN — Gov. Dave Heineman wants the federal government to provide health savings accounts for Nebraskans who buy high-deductible health insurance plans.
The governor made the request in a letter to U.S. Health and Human Services Secretary Kathleen Sebelius.
Heineman sent the letter more than two weeks after submitting an insurance plan with an $8,000 deductible for families as the minimum standard for individual and small group plans to be offered when the federal health care overhaul kicks in fully.
The high-deductible plan would be the benchmark for policies sold both inside and outside of the health insurance exchange to be created under the federal law.
State Insurance Director Bruce Ramge unveiled the letter Friday while briefing state lawmakers about Nebraska's progress toward establishing an exchange.
The exchanges — a centerpiece of the federal law — would allow people to compare and buy health insurance. People would have to go through the exchange to get federal premium subsidies.
In the letter, Heineman said his insurance proposal would reduce the federal government's cost for premium subsidies by keeping premiums lower.
“Consumers could better control their health care costs” if they have to pay more upfront, he added.
At the same time, Heineman said, a federal subsidy for health savings accounts would help people get their health care needs met and ensure that doctors, hospitals and other health care providers get paid.
Health savings accounts were created under federal law and allow people to save up for medical expenses, while saving on income taxes.
The accounts are available to people who buy high-deductible insurance policies, and money contributed to the accounts is tax-free.
However, there are limits on the amount that can be put into the accounts in a given year and limits on the uses of the money.
State Sen. Jeremy Nordquist of Omaha questioned whether federal officials would accept Heineman's recommendation. He said there is no provision for such an arrangement under the federal health care law.
He also questioned whether it would put health care in reach for many Nebraska families.
“For me, affordability is about how much does it cost to get you health care when you need it,” Nordquist said.
Under the federal law, states were to decide by Oct. 1 on an “essential health benefits” package to serve as a floor for health insurance. The package had to cover health care services in 10 key areas.
Heineman submitted the high-deductible plan that he called the “Nebraska Option.”
He said he chose the option because it would preserve an affordable insurance option for Nebraskans.
Ramge said federal subsidies would help make other insurance affordable for those buying within the exchange, but the high-deductible plan would help those buying outside of the exchange.
It was not among the choices set out by federal officials. It was also not among the options discussed at a Department of Insurance public hearing in August or among the plans analyzed by the department's consultant, Mercer Government Human Services Consulting.
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