IDEAS home Printed from https://ideas.repec.org/a/bpj/fhecpo/v15y2012i2p1-24n7.html
   My bibliography  Save this article

The Distributional Effects of Health Reform Limits on Flexible Spending Accounts

Author

Listed:
  • Cardon James H.

    (Brigham Young University)

  • Moore Joel

    (University of California, Los Angeles)

  • Showalter Mark H.

    (Brigham Young University)

Abstract

Flexible spending accounts (FSAs) are a widely used arrangement that allow employees to pay for qualified out-of-pocket health expenses with pre-tax dollars. The tax preference given to FSAs has been controversial and recent health care law (Patient Protection and Affordable Care Act and Health Care and Education Reconciliation Act) limits the tax exclusion to an inflation-adjusted value of $2,500 (2013 $s). The limit is estimated to increase federal payroll and income tax receipts by $13 billion between 2013 and 2019. But the welfare implications of this change are unclear.This paper uses a unique panel dataset to explore the demographic profile of households likely to be affected by the tax increase. We use a sample of 19,322 households observed over the period 1998–2008. The data include FSA expenditures, insurance claim information for covered medical and dental expenditures, and household demographic information. We explore patterns of FSA usage by income and health status.We find that households likely to be affected by the tax increase disproportionately tend to be households experiencing one or more chronic health conditions. The existence of chronic illness is associated with relatively high and persistent medical expenses and also with relatively older and wealthier households. We estimate an average tax increase of $101 in 2013 for 13.9 million households with an FSA.

Suggested Citation

  • Cardon James H. & Moore Joel & Showalter Mark H., 2012. "The Distributional Effects of Health Reform Limits on Flexible Spending Accounts," Forum for Health Economics & Policy, De Gruyter, vol. 15(1), pages 1-24, November.
    • Handle: RePEc:bpj:fhecpo:v:15:y:2012:i:2:p:1-24:n:7
    DOI: 10.1515/1558-9544.1310
    as

    Download full text from publisher

    File URL: https://doi.org/10.1515/1558-9544.1310
    Download Restriction: For access to full text, subscription to the journal or payment for the individual article is required.
    File URL: https://libkey.io/10.1515/1558-9544.1310?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Congressional Budget Office, 2010. "The Long-Term Budget Outlook," Reports 21546, Congressional Budget Office.
    2. Congressional Budget Office, 2012. "The 2012 Long-Term Budget Outlook," Reports 43288, Congressional Budget Office.
    3. Barton H. Hamilton & James Marton, 2008. "Employee choice of flexible spending account participation and health plan," Health Economics, John Wiley & Sons, Ltd., vol. 17(7), pages 793-813, July.
    4. Congressional Budget Office, 2012. "The 2012 Long-Term Budget Outlook," Reports 43288, Congressional Budget Office.
    5. repec:cbo:report:215461 is not listed on IDEAS
    6. James H. Cardon, 2010. "Flexible Spending Accounts and Adverse Selection," Journal of Risk & Insurance, The American Risk and Insurance Association, vol. 77(1), pages 145-153, March.
    7. Congressional Budget Office, 2012. "The 2012 Long-Term Budget Outlook," Reports 43288, Congressional Budget Office.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Jessica Leight & Nicholas Wilson, 2020. "Framing Flexible Spending Accounts: A Large‐Scale Field Experiment on Communicating the Return on Medical Savings Accounts," Health Economics, John Wiley & Sons, Ltd., vol. 29(2), pages 195-208, February.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Robert D. Lieberthal, 2016. "Hedging Medical Spending Growth: An Adaptive Expectations Approach," Applied Finance and Accounting, Redfame publishing, vol. 2(2), pages 57-64, August.
    2. D. Tverdokhlibova, 2018. "Theory and practice of the use of fiscal sustainability indicators," Economy and Forecasting, Valeriy Heyets, issue 3, pages 7-47.
    3. Kazumasa Oguro, 2014. "Challenges confronting Abenomics and Japanese public finance ?Fiscal consolidation must start by squarely facing reality?," Public Policy Review, Policy Research Institute, Ministry of Finance Japan, vol. 10(2), pages 301-318, August.
    4. Thomas Grennes, 2013. "Diminishing Quality of Fiscal Institutions in the United States and European Union," Cato Journal, Cato Journal, Cato Institute, vol. 33(1), pages 91-109, Winter.
    5. Nora Traum & Shu‐Chun S. Yang, 2015. "When Does Government Debt Crowd Out Investment?," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 30(1), pages 24-45, January.
    6. Hans B. Christensen & Eric Floyd & Mark Maffett, 2020. "The Only Prescription Is Transparency: The Effect of Charge-Price-Transparency Regulation on Healthcare Prices," Management Science, INFORMS, vol. 66(7), pages 2861-2882, July.
    7. Jonathan M. Harris, 2019. "Responding to Economic and Ecological Deficits," GDAE Working Papers 19-01, GDAE, Tufts University.
    8. Jeffrey B. Liebman, 2013. "The Deterioration in the US Fiscal Outlook, 2001-2010," Tax Policy and the Economy, University of Chicago Press, vol. 27(1), pages 1-18.
    9. David Greenlaw & James D. Hamilton & Peter Hooper & Frederic S. Mishkin, 2013. "Crunch Time: Fiscal Crises and the Role of Monetary Policy," NBER Working Papers 19297, National Bureau of Economic Research, Inc.
    10. Leonard Burman, 2013. "Pathways to Tax Reform Revisted," Center for Policy Research Working Papers 155, Center for Policy Research, Maxwell School, Syracuse University.
    11. Joseph Steinberg, 2019. "On the Source of U.S. Trade Deficits: Global Saving Glut or Domestic Saving Drought?," Review of Economic Dynamics, Elsevier for the Society for Economic Dynamics, vol. 31, pages 200-223, January.
    12. Christopher C. Afendulis & Michael E. Chernew & Daniel P. Kessler, 2013. "The Effect of Medicare Advantage on Hospital Admissions and Mortality," NBER Working Papers 19101, National Bureau of Economic Research, Inc.
    13. Shinichi Nishiyama, 2013. "Fiscal Policy Effects in a Heterogeneous-Agent Overlapping-Generations Economy With an Aging Population: Working Paper 2013-07," Working Papers 44941, Congressional Budget Office.
    14. Sebastian Rausch & Hidemichi Yonezawa, 2018. "The Intergenerational Incidence Of Green Tax Reform," Climate Change Economics (CCE), World Scientific Publishing Co. Pte. Ltd., vol. 9(01), pages 1-25, February.
    15. Leonard E. Burman, 2013. "Pathways to Tax Reform Revisited," Public Finance Review, , vol. 41(6), pages 755-790, November.
    16. Won-Sik Hwang & Inha Oh & Jeong-Dong Lee, 2014. "Assessing the Socio-Economic Effects of Korea's Nuclear Power Policy," Energy & Environment, , vol. 25(5), pages 931-952, July.
    17. Michelangeli Valentina & Santoro Marika, 2013. "Households’ uncertainty about Medicare policy," The B.E. Journal of Macroeconomics, De Gruyter, vol. 13(1), pages 151-186, January.
    18. Jonathan A. Schwabish & Julie H. Topoleski, 2013. "Modeling Individual Earnings in CBO’s Long-Term Microsimulation Model: Working Paper 2013-04," Working Papers 44306, Congressional Budget Office.
    19. Richard Peter & Sebastian Soika & Petra Steinorth, 2016. "Health Insurance, Health Savings Accounts and Healthcare Utilization," Health Economics, John Wiley & Sons, Ltd., vol. 25(3), pages 357-371, March.
    20. Davig, Troy & Leeper, Eric M. & Walker, Todd B., 2011. "Inflation and the fiscal limit," European Economic Review, Elsevier, vol. 55(1), pages 31-47, January.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:bpj:fhecpo:v:15:y:2012:i:2:p:1-24:n:7. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Peter Golla (email available below). General contact details of provider: https://www.degruyter.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.