The Commonwealth Fund is publicizing a new analysis that predicts health savings accounts will make health insurance available to only about 1 million of the 45 million Americans who are uninsured.[@@]

The Commonwealth Fund, New York, is a foundation that has backed earlier studies and analyses that have been critical of the HSA program.

The new analysis, developed by Sherry Gilead of Columbia University and Dahlia Remler of Baruch College, suggests that HSA tax incentives will have little effect on national uninsured rates, in part because about half of the uninsured owe no federal income taxes and joining an HSA program would provide a tax break of less than about $120 for most uninsured Americans with moderately high incomes.

If large numbers of employers who would be continuing to offer health benefits anyway shift to HSA programs, that could hurt low-income and moderate-income workers by increasing their out-of-pocket expenses without doing much to cut their taxes, the researchers predict.

But America’s Health Insurance Plans, Washington, has collected early survey data suggesting that early sales of HSA programs have been strong and that about 30% of the purchasers have been people who previously were uninsured, according to AHIP spokesman Larry Akey.

“The market is very young,” Akey says. “Nobody knows whether these trends will continue.”

Akey says AHIP believes the early HSA survey results are “very encouraging.”

“We’re not of the frame of mind that there’s one silver bullet” for helping the uninsured, Akey says.

AHIP would like to see government agencies, employers and others try a variety of approaches to solving the problem, Akey says.

The National Association of Health Underwriters, Arlington, Va., likes the HSA program, according to John Greene, NAHU’s legislative director for federal affairs.

“Many employers already have high deductibles,” Greene says, noting that the HSA program gives employees at those employers a new vehicle for handling expenses that they’ve had to handle all along.

NAHU also would like to see the federal government expand financial support for state programs that insure the health of residents with health problems, Greene says.

But Greene also suggests that some interest groups may be relying on incorrect assumptions about the plight of the uninsured.

About half of the “45 million uninsured,” for example, already are eligible for Medicaid, Greene says.