Vote Explanation for H.R. 1270 — Restoring Access to Medication Act of 2015

I voted against H.R. 1270, the Restoring Access to Medication Act of 2015, which would benefit those at higher income levels through an expansion of Health Savings Accounts (HSAs), paid for by increasing the cost of care for the poorest Americans. The bill would also repeal the Affordable Care Act (ACA) provisions that prohibit the use of Flexible Spending Accounts (FSAs) for over-the-counter medicines — provisions that help fund the law’s coverage improvements and expansions.

These changes disproportionately benefit higher income individuals, while working families with incomes starting at 250 percent of the federal poverty line would bear the brunt of the cost. The bill pays for changes to HSAs and FSAs by raising the limit on the repayment of tax credits that are available through the Health Insurance Marketplaces. Tax credits are given to low-income individuals in the form of a subsidy that is determined based on their income level. If a family’s income increases in the course of the year due to a promotion or change of employment, this impacts their subsidy and can result in their owing back money come tax season. As many people may not realize that their subsidy is contingent on income, they may fail to report an incremental increases in their salary, and so the ACA set a maximum allowable repayment amount of $2,500. This bill would lift that ceiling by $500 dollars, increasing the maximum allowable repayment from $2,500 to $3,000 — a significant sum for working families during tax season. As a result this policy is expected to decrease the deficit, but it is also projected to result in an estimated 130,000 becoming uninsured again, due to fears of owing back sums of money they cannot possibly repay.

The ACA is not perfect, but there can be no doubt that it has lowered costs and broadened access to care for many who were previously locked out of the insurance market. The Restoring Access to Medication Act of 2015 would have undermined critical ACA protections for low-income individuals while providing wealthier individuals with more flexibility in their insurance plans. While I do not dispute the aim of restoring flexibility in HSAs and FSAs, my colleagues should have found a better way of paying for these changes than a mechanism that would result in the people who are the most at risk becoming uninsured, again.