"Many who rely on flexible-spending accounts, including individuals and families battling chronic conditions with high out-of-pocket costs, will lose the full value of the benefit and be forced to pay higher taxes and health-care costs," says Joe Jackson, chairman of the Save Flexible Spending Plans coalition.

"There is always the danger when you are doing something as large as health-care reform of unintended consequences," says Dennis Triplett, chief executive of UMB Bank Healthcare Services and chairman of the Employers Council on Flexible Compensation (ECFC), a non-profit organization that advocates for expanding tax-advantaged employee-benefit programs. "When you are trying to reform a sixth of the economy in one sitting, you may well be doing something that looks appropriate but find out that you have caused angst and pain."

UMB Bank Healthcare Services, a subsidiary of UMB Financial Corp. ( UMBF), provides custodial services for health-savings plans to health-care providers, including Humana ( HUM) and Assurant ( AIZ). It recently surpassed $185 million in HSA assets.

According to the Employers Council on Flexible Compensation, 40% of U.S. adults age 20 to 64 have at least one chronic disease. Those individuals, even when insured, face thousands of dollars a year in out-of-pocket costs. FSA is broken down as follows: doctor visits and hospital deductibles (43%), medicine (26%), dental needs (21%) and vision care (10%).

Triplett is among those demanding that the planned cap on contributions be lifted and, in the future, be indexed to the rate of inflation.

-- Reported by Joe Mont in Boston.

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