The NYT devoted a major article to tell readers that flexible health spending accounts, the stupidest tax break anyone has ever been able to design, do not cover breast pumps. This is kind of like devoting an article to the fact that the rapidly growing Flat Earth Society holds meetings on the Jewish holidays.
Of course the real story would be the fact that a nutball organization is rapidly growing and the real story here is that an incredibly poorly designed tax break is continuing in this era of health care reform. Flexible spending accounts are wasteful from almost any perspective.
First the cost of administering the credit for companies is almost as large as the amount of the savings. Many organizations pay close to $100 per worker to administer the accounts. If a person puts $1000 a year into the account and is in the 15 percent bracket, like most workers, the tax savings are $150. If a worker puts the maximum $2,500 in an account and is in the 25 percent bracket, then the savings are $625. In this case, the administrative costs are still more than 15 percent of the tax savings.
This of course does not count the time spent by beneficiaries dealing with their accounts. There is often considerable paper work associated with these accounts. Often companies refuse to make payments, requiring participants to spend hours going back and forth with clerical workers in order to get reimbursements.
Flexible spending accounts also have an absurd use it or lose it provision. Extra money in an account at the end of the year is lost to the participant. This causes many participants to stock up on items like prescription glasses or over the counter medicines in order to avoid losing their money. Much of this spending is wasteful, since these are items that are not really needed.
Finally the credit is very regressive, since the largest benefits go the highest income individuals. It also is small business unfriendly since the administrative costs make it uneconomical for many small businesses. This puts small businesses at a disadvantage in trying to attract workers who might care about this benefit.
It is remarkable that such an incredibly poorly designed tax credit survived health care reform. (This is probably explained by the fact that most of the people who worked on designing the bill benefit from it.) It leads to more economic distortions that most of the forms of protectionism that get major news attention and cause columnists and editorial writers to hyperventilate (e.g. the "buy America" provision in the stimulus). The continued existence of these accounts merit attention, since it is a major scandal.
[Addendum: Several comments correctly point out that contributions to FSAs are also exempted from payroll taxes. This would add another 15.35 percent to the tax savings. So a person in the 15 percent bracket who puts $1,000 into an account would be saving herself and her employer a combined total of 30.35 percent of this amount or $303.50.]
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