December 18, 2008

The Future of HSAs

Expansion of HSAs under new Administration unlikely

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As of 2008, 9.8 million adults aged between 21 and 64 were either in a consumer-driven health plan or were eligible to open a health savings account (HSA), according to recent research by the Employee Benefits Research Institute (EBRI). The number of people enrolled in HSAs has increased steadily over the past years and will continue to rise, says Paul Fronstin, senior research associate at EBRI, even though the incoming Administration is not likely to do anything to support the expansion of HSAs.

"The President, the House, and the Senate are not going to undo what's already been done, but you're not going to see any calls to expand HSAs," he says.

If the new Administration and the Democrat-controlled Congress leave HSAs alone, their steady rise will continue, says William Sweetnam, a partner in the Washington, D.C.-based law firm Groom & Associates. "However, I am concerned, based on the hearing held earlier this year in the House Ways and Means Committee, that the Democrats do not see the potential of HSAs and they rather see them as an inefficient use of health tax dollars," Sweetnam says. "Any actions that they take to curb the tax advantages of HSAs will have a strong negative impact on the growth of HSAs. While I do not believe that they will outlaw them entirely (because so many people have HSAs), they might convince those individuals who were just starting to think about HSAs that they are not appropriate."

Still, there are close to 10 million Americans using HSAs now, Fronstin says, and both employers and participants continue to see the benefits to this type of healthcare plan. Among individuals with traditional employment-based health benefits and a choice of health plan, 40% were eligible for a consumer-driven health plan in 2008, up from 33% in 2006. About 22 million workers were eligible for such a plan in 2008 but chose to remain in a more traditional plan.

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