Are Flexible Spending Accounts Anti-Women?

Flexible Spending Accounts are a great way to set aside pre-tax dollars for medical expenses, but as we all learned this week, they don't cover everything. Some of the things they don't cover -- tampons, breast pumps, breastfeeding classes -- might suggest that they're anti-women.

These plans allow employees of companies who have it to set aside a portion of their income to pay for medical expenses -- co-pays, deductibles, and treatments. The IRS has the ultimate decision in what's covered because the FSA owner's money goes into the account before taxes are withheld.

This list of what's covered and what isn't is universal and, in some cases, seemingly arbitrary. For instance, childbirth classes are covered but not child rearing or CPR classes, and if you bring your husband along, that costs extra. You can't be reimbursed for that fee. Sterilization and most forms of birth control are covered, as is Viagra since prescriptions are covered in general.


A doula, on the other hand, is only covered if she has a medical license. And yet, the women who have used doulas learn more from them than from any "medical professional."

So, are these accounts discriminating against women?

It's easy to see both sides. Tampons are not covered, but then again, neither is toothpaste. Vasectomies are covered as are tubal ligations. Gender reassignment surgery, however? Not covered at all. Even though it's arguably a medical condition.

Plastic surgery is covered, but only if it's medically necessary. Vitamins aren't, but contact solution is. Maybe it's a radical notion, but how about we cover everything under the sun? If I set aside $2,500, why not cover my tampons, which are, after all, serving a public health purpose?

Cover my doula's and my husband's presence in the birthing room and cover my acupuncture to help me lose weight in order to be a healthier person overall. It's disconcerting that the IRS, the most bureaucratic and horrible of all government agencies, sits around and decides for me what's a legitimate medical expense and what isn't.

Do you think the FSA coverage is fair?


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