Washington is in the middle of one of the toughest negotiations in recent memory. Lawmakers are trying to settle on reforms that would modernize Medicare, the government health program for the elderly. But there are troubling signs that they might abandon the reforms most important for women.


Behind closed doors, congressional negotiators have weakened provisions to expand health accounts, which put control of health care back in the hands of patients and make health care affordable. Health accounts would enable women to save hundreds of thousands of dollars for their health needs in retirement. Congressional negotiators need to take a step back and consider how their actions will affect women.


Women’s lives are more intertwined with America’s health care system than men’s lives. We live longer, consume more medical care and tend to sick relatives more often than men. Of course we bear 100 percent of children, but we also choose the family’s health insurance, take the children to the doctor, and make sure they follow the doctor’s orders. When health care goes haywire, we are the first to feel the pain.


And things have gone haywire. The number of Americans without health insurance is rising, up 13 percent from the “crisis” days of 10 years ago. More employers are dropping health benefits, and many workers are giving up pay raises so they can keep their coverage. Health care costs continue to climb faster than personal income. The number of women who lack health insurance is climbing at three times the rate of men. In surveys, women are more worried about the health care system and about being able to afford health care in retirement.


What’s the matter here? Quite simply, the way we pay for health care in this country makes no sense: We single out employer-provided health insurance for preferential tax treatment. In layman’s terms, the government essentially bribes people to buy health insurance through their employer.


Few make the connection between how we pay for health care and the misery that surrounds us. But consider what would happen if we treated car insurance the same way. Most consumers would purchase car insurance through their employer. Geico would stop marketing to drivers and start marketing to employers. Soon, car insurance would cover more things – routine, predictable items like oil changes – because pre-paying through insurance makes those items tax-free as well.


Before long, we would have a feeding frenzy where workers – spending their employer’s money – would drive up the cost of insurance, maintenance and repair. Millions would no longer be able to afford auto insurance or a trip to the mechanic. Driving to job interviews would be very risky, since losing your job would mean losing your car insurance.


This is precisely what is happening in health care, and women are bearing the brunt. Women generally have lower incomes than men, spend less time in the workforce, have jobs where health benefits are less common and often depend on a husband’s job for insurance. It is no wonder that women are increasingly frustrated with a system that makes it almost impossible to buy health insurance anywhere but on the job.


Yet lawmakers have reportedly weakened a reform that finally would make health insurance work for women. Tax-free “health accounts” would allow women (and men) to save for their medical expenses tax-free. Both employers and employees could make tax-free contributions to the accounts, which would be the private property of the worker. They would cover out-of-purse medical expenses or health insurance premiums, including when a worker is between jobs. Whatever workers do not spend grows tax-free and is available for their medical expenses in retirement.


The benefits for women are enormous.


Health accounts expand women’s health insurance choices, enable more women to buy coverage, and make women less vulnerable to losing coverage. If anything, these provisions should be strengthened, not weakened.


Lawmakers have a golden opportunity to improve health care for women, now and in the future. America’s women will be watching.


Nancy M. Pfotenhauer is president of the Independent Women’s Forum. In this op-ed, which was produced for the Knight Ridder/Tribune News Service and printed by The Miami Herald and The Hartford Courant, the Independent Women’s Forum argues Health Savings Security Accounts (HSSAs) are essential to making health care more responsive and affordable for women, both before and during retirement.

An upcoming study by IWF estimates that under the House-passed HSA-HSSA provisions, Americans would save in the neighborhood of $365 billion for their medical expenses by 2013 and $3.2 trillion by 2030, the midpoint of the baby boomers’ retirement years. These assets would far outweigh the revenue loss to the Treasury and could be greater but for rules that would restrict HSSAs to those with low-to-moderate incomes.



An upcoming study by IWF estimates that under the House-passed HSA-HSSA provisions, Americans would save in the neighborhood of $365 billion for their medical expenses by 2013 and $3.2 trillion by 2030, the midpoint of the baby boomers’ retirement years. These assets would far outweigh the revenue loss to the Treasury and could be greater but for rules that would restrict HSSAs to those with low-to-moderate incomes.


An upcoming study by IWF estimates that under the House-passed HSA-HSSA provisions, Americans would save in the neighborhood of $365 billion for their medical expenses by 2013 and $3.2 trillion by 2030, the midpoint of the baby boomers’ retirement years. These assets would far outweigh the revenue loss to the Treasury and could be greater but for rules that would restrict HSSAs to those with low-to-moderate incomes.