hsa oar names. roy is a nationally recognized expert on health savings account and consumer direct it health care issues. he was there at the time of the delivery, both obstetrician and pediatrics to hsas. he did the hard work in terms of actually keeping things alive and moving them ton maturity. he was at the treasury department in their implement addition of hsa and full form in 20003 and then worked for president george w. bush as health policy adviser at the white house to carry on that work and develop implement addition of the medicare prescription drug ben and -- bet and is back doing it again, was the president of hsa consulting service with all kind useful information and advice on how these operate. ... to comment on the two presentations and the elaborate further because he has his views on policy and what's involving the onset. go ahead. >> thank you for including me today. i think it's important to keep the historical context of hsas in mind in all of this. they kind of take on and use

so talking a little bit about the basics of hsas, so the way it works is that hsas must be combined with a high deductible health plan or an hdhp, not to add to our alphabet soup. instead of traditional private health insurance that covers all of your medical care and needs with exception for copayments, maybe some coinsurance but covers your needs starting from day one with an hdhp, your traditional health insurance coverage doesn't start till you reach a pretty high threshold. before that time, either our responsible for paying out of pocket or you can use your hsa if it has money in it to cover those costs. i remember when i graduated from law school in 2004, i spent my first year working with employers to put in place he's hsas and hdhps. at the time, people were up in arms about the hsas and thinking, you know, this won't be good enough. people won't have enough of their expenses covered. today people are lucky if they have the hsa rz because whether they want to nor not, most people have been shifted toward higher deductible health insurance plans and frequently they just, they wou

hsa implementation actually. the federal law implemented for contributions and for the same time, state government can choose to narrow but offering the state income. i would like to use this and state legislation in several years because i think it provides an excellent for learning the causal effect and getting help ensure coverage. so, to do that, usually the policy the estate tax prize the state hoping to measure the actually a fact that the tax subsidy level. this table will show us the legislation between 2003 in 2011. i showed each state has their implementation and also i showed the state without any state, tax subsidies for they have no income tax. so every single empirical specifications using those policies. so it is now just if it is covered by a group insurance, i will give them one, otherwise zero. the key variable here is hsa. so the state has the income exemptions and lots of people have the reaction. for this specification i also control a law does individual characteristics, and the education le

and employers have provided other options before hsa's cable -- hsa's came along. known as flex savings account, all of which predated hsa is but have similar context of tracks -- context of tax treatment. although i would argue that fsa's and hsa's are much more grounded in terms of their black of flexibility as types of services that they can cover. having this change and tax parity for the out-of-pocket expenses, it is no longer necessarily in my interest to spend all of my tax preferred dollars on insurance that covers everything with little out-of-pocket expense because i can literally get the same tax treatment for my out-of-pocket expenses through the hsa. even better, the money that i put in the hsa is not used it or lose it as my insurance is or might fsa is at typically is my hra alternative also is. hsa can cover many things" whichal , not asealth related far as the broccoli and kale caucus would like us to go at this point, but steps in those directions. which i think is a positive thing when we look at health. most of us do not measure our health care

you listen to the coverage, they say -- you listen to the oh,crats, they say, [indiscernible] hsa's, devote the substantial resources to fight opioid and other substance abuse. will provide better coverage for low-income americans. by the way, low income americans, under our plan -- and we are doing things at this meeting, which i think you will be very happy about -- we are going to spend some more money to make sure everybody is protected. will provide better coverage for low-income americans. will approve medical outcomes for low-income americans. puts medicaid on a sustainable path, which is not on right now. levels the playing field for states when it comes to federal dawdle's -- federal dollars. and redirect a 30 from washington, d.c., to the states, which i already said, where they can innovate and develop the best practices and on a smaller basis they will be able to take care people better. , but we shouldl repeal and replace and we shouldn't leave town until this is complete, until this bill is on my desk and until we all go to the oval office. i will sign it and we can cel

we'll expand the hsas.ll devote substantial resources to fight opioid and other substance abuse. we'll provide better coverage for low-income americans. by the way, low-income americans under our plan -- and we're doing things at this meeting which i think you'll be very happy about. because we're going to spend some more money to make sure everybody is protected. we'll provide better coverage for low-income americans. we'll improve medical outcomes for low-income americans. puts medicaid on a sustainable path, which is not on right now. levels the playing field for states when it comes to federal dollars. reforms major entitlements, now a principle driver of the $20 trillion debt we have. and we'll redirect authority from washington, d.c., to the states, which i've already said, where they can innovate and develop the best practices and on a smaller basis. they'll be able to take care of people better. so we can repeal, but we should repeal and replace, and we shouldn't leave town until this is complete, u

a rand study in 2011 found that an hsa, a highly deductible plan with a deductible at at least $1,000uld reduce health care spending an average of 14%. that savings incurred not only for patients or but also for employers and for total health care expenditures. these more effective plans have been reduced under obamacare.mo most of the young people on my the reason they got hsas was because they did a little bit of a calculation, they did a littll bit of financial literacy. i that looked to see -- they looked to see what the plan was for the full coverage, and then they looked to see what an hsa would cost. and they said, well, gee.if if i take the difference in the cost between the regular insurance and the hsas and i put that in one of these savings accounts that can grow tax-free, in a maximum of three years i will cover any deductible that i might have. so they considered that to be good insurance, and they got to make a lot of their decisions. but i don't think we want individuals making their decisions. that appears to be how obamacare is constructed. and then there's an increas

we will expand tax-free health savings accounts, the hsa's to increase health care coverage, gettinghington out of the way and giving more control and funding back to the states, stabilizing exchanges so pre-existing conditions are protected. you listen to chuck schumer, before he knew what the plan said, he didn't see it, most of the people in this room never saw it, he said everyone will die, death, that's the only thing they're good at. plan, it's not just a good plan. this is far better than obamacare and more generous than medicaid whichg is on an unsustainable path and let states spend those dollars freely to the states can spend the dollars. as a smaller entity, the states will be able to take better care of a person with a bad back, with a bad prognosis, with a problem. i would like the federal government to focus on the middle east, to focus on north korea, to focus on things where we have big problems the states can do a better job than the federal government. when it comes to health care. that's what we are letting you do. billion toitting $45 help combat the opioid epidem

expands the use of hsas. these are priorities. we hope we can get republicans on board and send this to conference. >> bret: do you have a number? >> 50 is the magic number. that's the number we've been trying to hit. i think we will get there. i feel like if you are a republican conservative, this is a hard thing to be against. if you look at the four corners, these are the principles we are for. a lot of our members want to see this in conference. we have a chance to improve it, strengthen it. coming out of the senate, this is a bill that addresses a lot of priorities. gets us on the road to something better. >> bret: senator graham had this to say. >> i need assurances from the speaker of the house and his team that if i vote for the skinny bill it will not become the final product. it will be the vehicle to have a conference between the house and senate where we consider a true replacement. if i don't get those assurances, i am a "no." >> senator mccain, graham, johnson. do they have what they need? >> i think they do. if you

we're going to expand the health savings accounts, the hsas, toss help pay for health coverage. we're going to give funding and control back to the states, stabilizing the exchanges so those preexisting conditions are protected. you listen to schumer, and he didn't see it, most of the people in this room never saw it. and he was saying, death, death, everyone's going to die. this isn't just a good plan, this is a great plan, this is better than obamacare, and more generous than obamacare. a health care plan that's really on an unsustainable path and let the states spend the dollars freely. and as a smaller entity, the states will be able to take better care of a person with a bad back, with a bad prognosis, with a problem. i would like the federal government to focus on the middle east, to focus on north korea, to focus on things where we have very big problems. the states can do a better job than the federal government when it comes to health care. and that's what we're letting you do. and we're committing $45 billion to help combat the opiod epidemic, and some states in partic

(a) hsas. subparagraph (a) of section 223(d)(2) of the internal revenue code of 1986 is amended by striking "such term" and all that follows through the period. (b) archer msas. subparagraph (a) of section 220(d)(2) of the internal revenue code of 1986 is amended by striking "such term" and all that follows through the period. (c) health flexible spending arrangements and health reimbursement arrangements. section 106 of the internal revenue code of 1986 is amended by striking subsection (f). (d) effective dates. (1) distributions from savings accounts. the amendments made by subsections (a) and (b) shall apply to amounts paid with respect to taxable years beginning after december 31, 2016. (2) reimbursements. the amendment made by subsection (c) shall apply to expenses incurred with respect to taxable years beginning after december 31, 2016. section 110, repeal of tax on health savings accounts. (a) hsas. section 223(f)(4)(a) of the internal revenue code of 1986 is amended by striking "20 perc

we'll expand the hsas. we'll devote substantial resources to fight opioid and substance abuse. we'll provide better coverage for low-income americans by the way, low-income americans under our plan and we're doing things at this meeting which i think you'll be very happy about because we're going to spend some more money to make sure everybody is protected we'll provide better coverage for low-income americans we'll improve medical outcomes for low-income americans and put medicaid on a sustainable path, which it's not on right now, levels the playing field when it comes to federal dollars, now a principle driver of the $20 trillion debt that we have and will redirect authority from washington, d.c., to the states, which i've already said where they can innovate and develop the best practices and on a smaller basis they'll be able to take care of people better so we can repeal but we should repeal and replace and we shouldn't leave town until this is complete, until this bill is on my desk and until we all go over to the oval office. i'll sign it and we can celebrate for the am

we have to get things like hsa survey have pretax dollars to do that.also need to make sure the bill is that just about big insurance companies. it is currently $182 billion a stability fund which is a bailout on for the big insurance companies. it has to get back to block grants back to the states. that is state control. if connecticut wants single-payer, great. we don't need that in a place like utah. we can do much better at the le. a good dose of federalism is an import part of this, really empowering the little guy, forgotten men and women of get in control and get access to health care. we're not talking about health care outcomes. we've got to get there. lori: we have a long way to go to get there as you know. we appreciate your thoughts. thanks a lot. >> thank you on the lori. lea: another hot and muggy day across the country with no relief in sight. president saying we have independence day, but today is national hot dog day and really not an alternative to catch up for the windy city. >> each put ketchup on hot dog. it's just absurd. lori: let

it would allow people to use it a say -- use hsa accounts. it is one change that is important. host: let me talk to about medicaid. it is a fundamental issue. if you are a governor of a state and you receive a block grant and you cap out, what happens to those individuals who the health care? guest: that is a decision you and your legislature have to make. if you have more expenditures than the cap level, do you reduce the number of beneficiaries? do you reduce the services offered? do you require beneficiaries to pay more? these are tough choices that have caused concern for folks. vacate covers 70 million americans -- medicaid covers 70 million americans. making it a cap allotment and exposing governors and legislators to the -- you are talking that is a great concern. the republicans feel it has to be reduce on the federal side. it made this decision in this bill to repeal and replace the afford will care act -- the affordable care act. host: this is why we are facing a $20 trillion debt? guest: it has grown. there has been a need for it. that is what the advocates would exp

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. >> if they had gone to repeal and replace like they said, deductibles,cing reducing premiums, hsa, think we would be in a different spot. >> you're making my argument and that is if you can get republicans -- if they didn't overreach, if we could have a serious conversation about solving the problem, you could get there. but again, back to your first question, it took me a while and washington to figure this out, but washington -- congressman, tell me if i am wrong. a lot of it is preparing for the next election and controlling the news cycle today to prepare for the next election. because that other team on not do anything right, they will always be wrong, but we will do it right. so, let's not do anything until we have power and we just go back-and-forth. again, i go back to the argument that a lot of this we are discussing about issues at a federal level and everything being one way as opposed to allowing a little more flexibility and space. >> i think there is truth to that in terms that the president -- during the obama demonstration that didn't exist during the bush administr

a, hsa, subparagraph a of 32-2-2 is amended by striking such term and all that follows through the period. b, archer, subparagraph a of internal revenue code of 1986 is amended by striking such term and all that follows through the period. c, health flexible spending arrangements and health reimbursement arrangements. sections 106 of the internal revenue code of 1986 is amended by striking subsection f. d, effective dates. one, distributions from savings accounts. the amendments made by subsection a and b shall apply to amounts paid with respect to taxable years beginning after december 31, 2016. two, reimbursements. the amendment made by subsection c shall apply to expenses incurred with respect to taxable years beginning after december 31, 2016. section 111-a, section 223-f-4-a of the internal revenue code of 1986 is amended by striking 20% and inserting 10%. b, archer m.s.a.'s, section 220-f-4-a of the internal revenue code of 1986 is amended by striking 20% and inserting 15%. c, the amendments made by this section shall apply to is distributions made after december 31, 2016. section 1

the senate would allow people to use hsa's health savings accounts which is deferred money to use that to pay your premiums, that is one change very important. >> medicaid is such a fundamental issue. so if you're governor of theof state and you received a block grant cap out what happens to those individuals who need healthcare? >> that's a decision you and your legislator have to make. if you have more expenditures and you dip into next year's allotment, do you reduce the number of beneficiaries, to reduce services offered, do to the beneficiaries more money of their own? these are tough choices that of cause concern because medicaid covers around 70 million americans. it pays for two thirds of nursing care and half of all the births. this idea making it a cap allotment and exposing governors and legislators is a great concern. republicans feel that medicaid spending on federal side has to be reduce in taps and limits on it. so they made this decision to repeal and replace the affordable care act and pursue this entitlement reform. >> and his medicaid reform one of the key reasons we

so what we've got to do, got to have hsa expansion under massive scale. introduce things like pro bono health care, where doctors get a tax deduction for treating people for nothing, and that will cover seven million poor americans that don't have insurance now. part of the 27 million who still don't have insurance under obamacare. gerri: steve, look, anthem said they may pull out. talk about raising rates but they said we could just go, and we already know there are other health insurers out. isn't the senate fiddling while health care is burning right now? >> very much, gerri. i think anthem left three states, i believe so far. and may leave all the states in the united states, and by the way, who can blame them? if i were a shareholder, i'm not, if i were a shareholder, i would say yes, you should not participate in this system if you're not going to get the subsidies that were promised to you under obamacare. but i think you're exactly right. they're fiddling while rome burns. the health care system of america is badly broken mainly because of governm

hsas, or health savings accounts, those could now go towards paying for premiums. that's something else that conservatives wanted. an extra $45 billion would now go towards opioid funding. and now the important part -- this bill would keep the very steep cuts to medicaid that a lot of moderates had issues about. that is going to be the key issue and the key debate to watch in the coming days for members like dean heller, shelly moore-capito, rob portman. they need to win over some of those senators. that's what all of the discussions will be all about in the next coming days. >> you will be tracking all of it, m.j. lee. >>> just moments from now, house minority leader nancy pelosi is set to speak on the russia investigation. she's already called for jared kushner's security clearance to be revoked. so will she double down? i'll ask a republican congressman what he thinks should happen. >>> plus, timeline questions. president trump says he learned about his son's meeting with the russian lawyer just a few days ago, but a new report says his lawyers have known for we

to this end, we propose providing plan sponsors the option of an -- adding an hsa feature to their 401(k) as congress did when it allowed 401(k) providers to add an i.r.a. to their plan in 2001. integrating hsas into the 401(k) in this fashion has the benefit of providing participants with access to lower cost investments offered in the 401(k), and wholistic financial advice for savings for both health and retirement needs. i applaud this committee's work to make tax rates on small businesses more competitive by reducing the tax on passthrough income. in that spirit, i want to highlight a technical issue related to small business retirement plans. it is critical that retirement plan contributions by shareholders or partners of passthrough entities be deducted only against the income that is classified as reasonable compensation. the value of offering a retirement plan to employees is preserved when the tax rate related to the deduction matches the tax rate the employee will pay when they retire. thank you again for the opportunity to participate in this important discussion. i would be

there are some things like hsa flexibility that would help people in some ways, but i don't know how the whole thing looks together, because when you is -- >> i want to talk about skinny repeal in a second, but susan, let's step back and look at the political consequences again. here you have the republican senate defeating repeal and replace and just now defeating straight repeal. what do you think the big picture consequences are of that? >> they only run on this issue in four consecutive sections and won by writing it, so i think the political consequences are serious. i think base supporters, the people for whom this was an important issue, and something they believed republicans would vote on, this is the stuff in washington that drives people crazy. if we look at the next election, the fifth election in which health care will be a critical issue, you can hear white voters saying why don't they do it? >> six senators previously voted for repeal only when obama was in the white house and they knew he wouldn't sign it, and then today voted against it. >> the law of what it would a

so-called skinny bill, repeals individual and employer mandates, provides flexibility to states, increases hsaontributions, repeals medical device tax, and funds community health centers. the bill does not include any cuts to medicaid. >> earlier president trump cheered on his gop colleagues. he tweeted out: go republicans senators, go. get there after waiting seven years. give america great healthcare. let's listen here. we're hoping to get a tally momentarily. >> you're watching with us live right now from the senate chambers in the nation's capital here as u.s. senators are underway. the roll call is underway right now on the so-called skinny repeal of obamacare. >> mr. cruz, aye. >> sometimes there are a lot of different formalities and whatnot they go through with the u.s. senate but the vote has happened. they're counting up the votes. and hopefully we'll get the results momentarily. again, as we mentioned, the republicans need 51 votes. they can only lose two votes. >> mr. heller, aye. >> the key vote tonight, as we mentioned, was senator john mccain. kind of a linchpin here. and he vot

through freedom of choice, buying groups across state lines and letting people save more money in hsa's, the problem with republicans is they have insufficient confidence in what made america great and that's capitalism, freedom of choice, competition. greg: your colleague from nevada has suggested that this was his idea as well. he sent a letter to the president saying that if the senate does not have a bill by the tenth of july, let's go ahead and do the repeal and replace separately and let's work through the august recess in order to get this all done, would you sign on to the idea of working through the august recess? >> i'd rather get it done before that. i think you can do this in the next three weeks. there are other bills out there that are sitting around that have bipartisan support, separate repeal and replace, if there are big government spending programs, put them on some other bill but the thing is you can't get conservative votes or you can't get my vote if this bill with a bunch of federal spending. greg: sorry, we are having trouble there with the signal. senator paul h

in terms of these plans, i would raise the point that this health savings account, hsa's, as they are known, have been a popular policy prescription for the conservative wing of the party that was touted frequently during the lead up to the 2016 election by people like dr. ben carson, now secretary carson, as well as the host of others, including dr. rand paul, senator paul. this is very much in that wing of the process. they would argue that if you have a health savings account and you're going to be a first-time user of that, if you are a young person or someone with a pre-existing condition, that would incentivize you to get into the health care market. senator lindsey graham who wants to bolster power back to the states, send more power back to the states, that's much more in line with the thought process we heard consistently for several years. vonnie: i want to ask you a quick question. the cbo has come out and found the deficit in 10 years time under president obama 2018 budget and projections would be $720 billion. the administration would not be balancing the budget. trillion

hsas allow to you set aside pre- tax money to pay for unreimbursed billing costs.now it's hard to believe, but billing departments, doctors, healthcare facilities, they actually may be open to negotiation. that's especially if you offer something that will make their work easier like maybe you can pay in advance or maybe you can use cash. finally, don't forget to ask for generic drugs. be sure that the tests or prescriptions that are prescribed to you are really necessary. and here's a big one. check every bill for coding errors. now, there are groups that review bills on patients' behalf. they say the error rate on these bills can run up to 75%, hundreds of thousands of dollars, sometimes we don't even look at them and we don't know what we're paying. so take a look at those bills. they are tough to decipher but it could be worths your time. >> that's just one of many problems in our healthcare system. good tips this morning. jill schlesinger from new york city, thank you. >>> 5:42. the resignation of uber's ceo is at the center of the company's legal battle over

i would like to have that, some hsas that people can bank and grow tax free and serve as a retirementle as well. that will solve the cost. as soon as you are paying out of your pocket, the costs go down. >> 535 members have an idea of how to fix health care. the option that is presented to the senate, repeal now, replace later. do you support that? >> yeah. i mean, in terms of where we are. i don't see much of an alternative. we voted on the 2015 repeal bill. all the senators voted for it, the house members, maybe one or two exceptions and it pass zed. we are going back to basics. that's what we promised, voted on and said we were going to do. the senate bill is nowhere near a repeal. we are going to have a federally run program with subsidies run out of here. everything the federal government touches is upside down. social security, medicare are insol vant and we have 130 trillion in liabilities. >> who deserves the blame for where things are now? we have great reporting from dana bash who says a senior official said there's blame to go around, but also the white house deserves blame

they also want to allow people to use their hsa payments or their allowance pretaxed to pay for premiums's something you're not allowed to do now. $45 billion allotted to combat the opioid they are keen on getting into this bill. this is one of the most important aspects of this bill, there aren't any dramatic changes to medicaid from the previous bill, and that's one of the reasons that a lot of moderate senators have been concerned, big and deep cuts to medicaid down the road that they're unhappy with, but moderates are happy with this provision. there will be no repeal of the obamacare taxes on the wealthy. there is one key senator who has been somewhat of a purity person when it comes to this. he wants to be a full repeal, and that's ted cruz. sounded a little bit different today after they emerged. take a listen to what they had to say. >> it's not the ideal bill i'd like it pass. i suspect there may not be an ideal senator, but it does represent a bill that reflects the concerns expressed across the conference. that's how we actually come together and honor our promise to repeal ob

then the hsa payment on premiums, your own spending accounts.ed for substance abuse, opioid treatment, they think that will fill the gap of what people need, no changes to medicaid from the previous bill. the previous bill had $772 billion cuts to medicaid over the next ten years. no repeal on the obamacare taxes on the wealthy. i think this is what rand paul objects to. karoun, what do you see? >> i think about two weeks ago, ohio governor john kasich said the $45 billion is a nice number, but it's basically a drop in the bucket, a band-aid on a gushing wound of the opioid crisis. i think the problem for a lot of republicans is that they have governors at home who won't be convinced by all this at all. that's the case in ohio, those are two moderate republicans looking at this. we haven't heard all that much from the arizona republicans. they're also from states that have issues with opioids and other drug crises and also a population that's not all that young. so you're looking at basically who it is that has to make the decision to vote for t

people being able to use their hsa money to buy their health care plans.ther those changes might be enough to bring everyone from sort of susan collins on one end of the republican spectrum to rand paul on the other or enough of those noeks back on board to get them above that 50 vote threshold. and that we just won't know until we see this bill. >> all right. we'll continue with that conversation in a little while. hang on. my control room is just telling me something that -- let's go to kristen we will ker, who was at the white house presser which was resident televised. it was done in audio. kristen, what did you hear? >> reporter: hi, ali. a couple of headlines from the briefing today, particularly relating to that story that you've been talking about throughout the hour, donald trump jrn's meeting that we've learned about with a kremlin linked lawyer back in june just days after his father had secured the nomination. sarah huckabee sanders defending the meeting, saying that it is standard practice for people in a campaign to meet with people who may h

are big increase in the money of open oids, allowing people to use their hsa spending accounts to payremiums. the most controversial item and get some of these conservatives back is this ted cruz amendment that would allow people to buy essentially stripped down cheaper plans with the thinking you could get more people insured, get premiums down. >> will is that be enough, though, to get this thing passed? are there enough conservatives that would say enough to this cruz amendment for mitch mcconnell to be able to bring this to the floor for a vote? >> that's the million dollar question. bring all the conservative back on board and still be in trouble. dean heller of nfd seems like a very hard know who is far more popular than he is brian sandoval decides to back this bill. susan collins still sounds like she's a very hard no. someone like rob portman or she will la are going to be more tricky to bring back on. so if you've got those two moderates, that's it. i don't think the crews amendment in itself will be enough. we have to see what other changes will be able to make in this bill

coverage that individuals ought to have, if they select something else, for example, if they select an hsa, a health savings account with a high deductible catastrophic plan that doesn't count in cbo's formula. cbo doesn't even capture those individuals who say to the federal government i don't want the plan that you think i need. i want the plan that i know i need for myself and for my family. so those numbers are so flawed in terms hoff what actually -- in terms of what actually happens in the real world when people act for themselves in an appropriate way and get that kind of coverage they want. >> it is pretty incredible when you look at the healthcare system in america, versus elsewhere. you know, all you have to really do is what's taking -- is look at what's taking place overseas with charlie gard, the european court of human rights effectively handed gard a death sentence on june 27th when it ruled the terminally ill baby should be pulled off of life support. his parents obviously want to see if there's some experimental way to keep him alive by taking him to the united states. but

hsa payment allowance on premiums, $45 billion for substance abaaoud opioid treatment, no changes torom previous bill, no repeal on obamacare taxes for the wealthy. the first item, the so-called cruz amendment, the option for a cheaper plan with fewer benefits. what would that change do? >> first of all, that makes this bill even worse than the original bill that mitch mcconnell proposed because this will totally destroy the individual insurance market. here is what happens. in the exchanges where there are these packages that have to have the ten essential benefits, you'll have people who have illnesses or who are old -- older, will purchase there, but young healthy people who want a skinny package will go outside the exchanges, and they will get these very skinny packages. the result is, you have the so-called adverse selection where only the sick are in the exchanges. they drive the premiums up because they tend to use more health care and the exchanges collapse. the insurance companies hate this for that reason. basically it benefits young healthy people who can pick and choose a

to make ted cruz happy, allowing cheaper plans that don't cover as much and allowing people to use hsaspay for their premiums. they're also sort of throwing money at the problem of getting more moderates onboard. they've upped the amount of money they want to spend on open yoids to $45 billion from $2 billion. there's about a $70 billion fund to offset some of the costs that are going to go to different states. and there's lots of other nuggets packed in around the edge of this bill that we're going to have a better idea of what they mean and what they do when the cbo report comes out. that's the next big step in figuring out how they might pass this thing. they're expecting to get a cbo score as early as monday or tuesday of next week. yesterday mitch mcconnell said he was confident they would still vote next week. but as you said right now you have the two hard no votes. i spoke to susan collins at length yesterday, she was a very hard no in part because they didn't make any of the changes that she and other moderate senators wanted to see on medicaid. so those four undecided senators

you probably want to limit supplemental insurance, how hsas can be used in different ways that can be useful depending on what the money is allowed to be used to pay for, transparency in pricing. so long overdue in our health care system, figure ought more transparency in pricing of health care, critical component. tort reform, so we do more so there's not excessive preventive providing of health care to avoid lawsuits and it's more about health. finally the tax treatment of health care. we subsidies health insurance through the tax code, through the healthcare exclusion and in a way that economists on all sides of the aisle agree is inefficient and drives up the overall cost of health care. that would be a great policy to look at to limit the healthcare exclusion which could provide more revenues to shore up the healthcare system to bring down the debt. a whole lot of things, and one of those rare two fers right now in policy writ would be good tax treatment and tax policy and good healthcare policy. a three-fer, good fiscal policy. i'm ware where when people say something is like a

how hsa's can be used in different ways depending upon what the money can be used for. transparency and posing as so long overdue. figuring out transparency in health care is a critical component. a few others. more.eform so we do so there is not excessive preventative providing of health care to avoid lawsuits but it is more about health. finally, the text treatment of health care. the subsidized health care. on all sides of the aisle. agreed it is inefficient. it would be a great policy to look out to limit the health care exclusion which could provide more revenues to shore up the health care system, bring up the debt. a whole lot of things. it is one of those rare things and policy where it would be good tax treatment and policy and health care policy. policy.od fiscal i'm wary of when people say something is a win-win situation because they are trying to sell you something for free when it comes to budget policy but i think looking at the health care solution can in fact be a win-win-win. the details are so important. the big picture is also so important, which is

hsas can be used in different ways. and i think transparency in pricing. this is so long over due in our health care system but figuring out more transparency is a critical component of this. tort reform so that we do more so there's not excessive presentative providing of health care to avoid lawsuits but that it's more about health. and finally the tax treatment of health care. we subsidize health insurance through the tax code, through the health care exclusion in a way that economists on all sides of the aisle agree is inefficient and drives up the cost of health care. that would be a great policy to look at to limit the health care exclusi exclusion. it's one of those rare twofers right now in policy where it would be a good tax policy and good health care policy. it would also be good fiscal policy. i'm always wary of whenever people say something is a win-win. it usually means they're trying to sell you something for free. but i think looking at the health care exclusion could in fact be a win-win. the details are so important. and the big picture i

first dollar coverage which can undermine price activity, you probably want to limit insurance, how hsa's can be used in different ways that can be useful depending what money is allowed to be used to pay for it. and i think transparency in pricing, this is so long overdue in our healthcare system, figuring out more transparency in the pricing of healthcare is a critical component. i put out to other court reforms that we do more so there's not such a preventative providing of healthcare to avoid lawsuits but it's more about health and finally, tax treatment of healthcare, we subsidize health insurance through the tax code through the healthcare exclusion in a way that economists on all sides of the aisle agree is inefficient and drives up the overall cost of healthcare. that would be a great policy to look at to limit the healthcare exclusions which could provide more revenues to shore up the healthcare system, bring down the debt, a whole lot of things and it's one of those where first in policy where it would be good tax treatment and tax policy and it would be good healthcare policy.

to this end we propose providing sponsors, withng the option of adding a hsa feature to their 401(k) as allowedss did when they payers to add in ira plan to their 401(k) into thousand one. this has the benefit of providing access to lower-cost investments offered into the 401(k), and holistic financial advice for savings for health and retirement needs. i applaud this committee's work to make tax rates on small businesses more embedded by reducing the rates on half their income. i want to highlight a technical issue related to small business retirement plans. it is critical that retirement plan contribution by bereholders or partners deducted only against the income that is classified as reasonable compensation. the value of offering a retirement plan to employees is preserved when the tax rate related to the deduction matches the tax rate the employee will pay when they retire. thank you again for the opportunity to participate in this important discussion. to discusspleased these issues further with the committee and answer any questions you may have. >> thank you, mrs. stout. mr.