Obama makes it harder to quit smoking

President Obama's aides confess, on occasion, that the boss had some trouble kicking the nicotine habit. But Robert Gibbs, the White House press secretary, reported on Twitter the other day that Obama has not smoked a cigarette in nine months, though he still chews Nicorette gum.

So two cheers for the president. Ditching the smokes while leading the Free World is no minor accomplishment. And Obama shouldn't be ashamed about using a bit of nicotine replacement to ease those nasty withdrawal symptoms, which can include testiness and difficulty concentrating.

It is a little surprising, though, that the president's health-reform laws just made it lot more expensive for many of us — including me — to buy the kind of over-the-counter products that help recovering tobacco addicts stay away from the always-alluring golden leaf. I prefer lozenges, the president chooses gum, some quitters opt for the patch.

None of these anti-smoking tools is cheap. I usually pay $46 for 72 lozenges. I'm easing back, but my monthly bill runs close to $100 — still a relatively small price for what, with a bit of luck and persistence, should lead to a longer, healthier life.

Last year, I bought Nicorette lozenges using money from my health savings account (HSA). Thanks to Obamacare, I can't do that anymore. The same is true for people who have a flexible spending account (FSA), a health reimbursement arrangement (HRA) or an Archer Medical Savings Account (MSA).

This alphabet soup of government-sanctioned accounts shares one goal: allowing people to save and invest money tax-free so they can better meet their personal medical expenses — and exercise more control over their own lives. So the accounts are, of course, not very popular in the Obama White House.

Health savings accounts are designed to encourage wiser and more frugal consumption of medical products and services. The big benefit is lower insurance premiums, which I have enjoyed for several years. Personal responsibility pays off.

But Obamacare makes these accounts less attractive.

Beginning Jan.1, after-tax savings can no longer be used to purchase over-the-counter medications (except insulin) unless the patient receives a prescription. ("Doc, will you write me a scrip for some Advil? And Robitussin? And maybe some Rolaids while you're at it?") This is one "reform" that won't improve the efficiency of our health-care system or lower costs.

Here's what the IRS — which is responsible for overseeing several aspects of the Patient Protection and Affordable Care Act — recommends:

"If your employer's health FSA or HRA reimburses these expenses, you would provide the prescription (or a copy of the prescription or another item showing that a prescription for the item has been issued) and the customer receipt (or similar third-party documentation showing the date of the sale and the amount of the charge). For example, documentation could consist of a customer receipt issued by a pharmacy that reflects the date of sale and the amount of the charge, along with a copy of the prescription; or it could consist of a customer receipt that identifies the name of the purchaser (or the name of the person for whom the prescription applies), the date and amount of the purchase and an Rx number."

Under the old system, most of the time you just gave the pharmacist a debit card tied to the savings account — and walked out the door with whatever you needed.

No more. But you can still use your health savings to buy (along with insulin) crutches, bandages, blood sugar test kits, and other types of over-the-counter "medical devices and supplies."

Confused yet?

Here's the bottom line for me: Before Obamacare I earned $100, plopped it into a health savings account and used the money to buy an OTC product that made it much easier for me to not smoke cigarettes.

Now I have to earn $142 a month — after paying my middle-class income and payroll taxes — to buy the same $100 worth of nicotine lozenges. Plus, my employer has to pitch in an extra $10 in payroll taxes.

So it just got 50 percent more expensive to quit smoking, unless I want to jump through an absurd number of hoops — and probably pay my doctor $100 for a visit.

When people describe a government takeover of health care, this is what they're talking about — less freedom, more red tape, higher costs, bad incentives, reams of nonsense.

I don't intend to smoke a single cigarette this year. But Barack Obama just made it harder.

brayner@timesdispatch.com

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