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For the first time in history, the IRS is weighing in on “the degree to which doctors should be recommending … food and exercise” to their patients, said health advocate Calley Means.
In an appearance on the “RFK Jr Podcast,” Means discussed a March 6 IRS “reminder” warning that people who use health savings accounts (HSAs) and flexible spending accounts (FSAs) will no longer be able to deduct “nutrition, wellness and general health” expenses — even if a doctor provides a note recommending them — unless they are “related to a targeted diagnosis-specific activity or treatment.”
Gym memberships can count as a medical expense only if recommended by a doctor for the sole purpose of treating an injury or a specific medical condition like obesity or hypertension, according to The Washington Post, which reported on the IRS alert.
Means told Robert F. Kennedy Jr., Children’s Health Defense chairman on leave, that the IRS policy would make the childhood health crisis in America even worse by prioritizing pharmaceutical interventions over nutrition and wellness.
Means, co-founder of Truemed, a company that helps people leverage tax-advantaged HSA and FSA funds for “food, exercise, or supplement interventions [that] can prevent or reverse disease,” said the IRS alert sets a higher bar for using these accounts for preventive measures, such as healthy food and fitness, than it does for drugs such as Ozempic, a popular weight-loss medication.
“The IRS is literally saying it is easier and clearer and [will bring] less scrutiny … to get a prescription for Ozempic than to work with your doctor to get a detailed food/supplement/exercise plan,” he said.
Before the IRS issued this latest alert, it had routinely allowed HSA and FSA funds to be used “for exercise, for dietary intervention, for supplements to reverse or prevent conditions” if a doctor “know[s] how to write” the plan, Means said.
“The law is that … if you’re prediabetic, if you’re dealing with heart issues … [or] obesity, you can actually get a medical letter from your doctor with a detailed dietary plan,” he said.
IRS favors drugs over wellness
HSAs, FSAs and similar health spending accounts allow people to set aside a portion of their income pretax to pay for an array of medical and dental expenses, including prescription drugs, vision care, doctors’ expenses (including co-pays), birth control pills, fertility treatments, hearing aids, physical therapy — even acupuncture and psychiatric care.
Parents can legally use their HSA or FSA funds to help pay for healthcare for their dependent children, stepchildren or foster children through age 18 (age 23 for full-time students). Other family members may also qualify under certain conditions.
In its recent alert, however, the IRS warned, for example, that food can be considered a medical expense only if it is recommended by a physician to treat a specific illness, does not satisfy normal nutritional needs, and the cost is over and above normal food expenses.
With the IRS reportedly now targeting people who may be accessing HSA funds outside of its rules, taxpayers may be required to pay ordinary income tax on such distributions — plus a 20% penalty if under age 65 — according to Yahoo Finance. Those with FSA accounts will have to redeposit the funds they used.
Means told Kennedy that Americans have $150 billion in health-related tax-advantaged accounts, which may be why a “pharmaceutical lobbyist who was upset with what we [Truemed] were doing tipped off the IRS.”
“Let’s call this what it is,” Means said, “an attempt by regulators to confuse and freeze the trend of Americans learning that they can work with their doctors to reverse disease with food, not drugs.”
Youth diabetic, reproductive issues ‘genocidal’
During the podcast, Means cited several statistics, including that 25% of young adults have fatty liver disease, 33% of teens are pre-diabetic and nearly 50% of children are overweight or obese.
“We have cancer exploding among kids,” he added, also noting a recent New York Times article on plummeting fertility and birth rates worldwide.
Kennedy pointed out that chronic diseases that were rare in children when he was young — for example, autism, allergies and autoimmune disorders — have skyrocketed.
“I never saw kids with autism,” he said, “and then suddenly they started appearing in the mid-1990s. … We went from 1 in 10,000 to 1 in 34.”
Kennedy also noted the sudden appearance of peanut allergies and juvenile or Type 1 diabetes, which were almost unheard of in previous generations.
Means highlighted the staggering rise in childhood obesity and diabetes. “When I was a kid, a typical pediatrician might see one juvenile diabetes [case] in his career and today … 1 out of every 3 is pre-diabetic or diabetic.”
The consequences of this chronic disease epidemic are “genocidal” in Means’ view. With a generation of young people “who are going to be diabetic and, frankly, infertile, our literal reproductive systems are shutting down,” he said.
“This is the biggest issue in the country,” he said, calling it “existential.”
“It’s also an economic catastrophe,” Means said, because the current incentives “just explode costs with the healthcare system.”
Kennedy agreed. “It’s costing us $4.3 trillion a year. … That’s bankrupting us. We’re destroying our country. When my uncle was president, 6% of the GDP [gross domestic product] went to healthcare,” he said. “Today it’s 22%.”
‘First line of defense for chronic conditions for kids is a prescription pad’
Means and Kennedy attributed the childhood epidemic of chronic disease to a healthcare system that profits from chronic disease.
They said the food and pharmaceutical industries have corrupted medical institutions, federal agencies and even social justice organizations to keep Americans, especially those in lower income brackets, dependent on their products.
“Plainly, pharma and the healthcare industry is the top funder of politicians, the top funder of the media, the top funder of med schools, the top funder of research, the top funder of civil rights groups — the top funder of every single group that we trust,” Means said.
Means provided examples of industry influence on trusted medical organizations.
Recalling his early career as a consultant for the food and pharma industries, he said “The American Academy of Pediatrics actually did partnerships with Coke [Coca-Cola].”
He also mentioned that the American Diabetes Association took millions of dollars from Coca-Cola, despite the role of sugary drinks in driving diabetes rates.
These groups, Means argued, “are nothing more than public relations entities” for the pharmaceutical industry, yet they have “quasi-governmental authority to make the standard of care” for doctors.
“That is why the first line of defense for chronic conditions for kids is a prescription pad,” he said.
Means also recounted how the American Beverages Association and soda companies paid the NAACP millions of dollars to say, “They’re taking away a Coke from poor kids.” The NAACP and their allies “went out and said it was racist to take away Coke from kids,” he said.
Means also criticized the training doctors receive, suggesting it fails to address the root causes of health issues and instead focuses on “pharmacology [but] not a single class on nutrition.”
Means said his sister Dr. Casey Means, a graduate of Stanford Medical School, “did not learn in 11 years … what causes inflammation.” Doctors, he said, are taught that “their only job is to stand ready with the scalpel and the prescription pad when these lazy American patients come to them.”
“The best possible thing economically for the pharmaceutical industry is for a kid to get metabolically unhealthy early because then you’ve got them,” he said.
“The American people are not trying to be sicker, fatter or more depressed [or] more infertile,” Means told Kennedy. “We’re pushing trillions of dollars of incentives for kids to eat poisonous food, eventually get sick, and then get on a pharmaceutical treadmill.”
Means said that even health insurance companies make more money from chronically ill policyholders because the increased demand means they can raise premiums.
The Defender contacted the press offices of the Biden administration and the Trump campaign for comment on the IRS alert but received no responses by the time this article was published.
Listen to the ‘RFK Jr Podcast’ with Calley Means on Spotify:
The Defender on occasion posts content related to Children’s Health Defense’s nonprofit mission that features Mr. Kennedy’s views on the issues CHD and The Defender regularly cover. In keeping with Federal Election Commission rules, this content does not represent an endorsement of Mr. Kennedy, who is on leave from CHD and is running as an independent for president of the U.S.
