The Employee Benefit Research Institute has been raising doubts for years about the ability of health savings accounts to save the U.S. health finance system.[@@]

America’s Health Insurance Plans, Washington, recently reported that insurers have sold about 1 million HSA-compatible health insurance policies.

But Dallas Salisbury, president of EBRI, Washington, says he still believes that researchers need more data to determine if HSAs and “consumer-driven health plans” can do much to hold down health care costs or help employees save for post-retirement health care costs.

Employers still aren’t offering HSAs to all that many employees, and even employees who can choose between traditional health insurance plans and HSA plans may need more information about the HSA plans, Salisbury says.

The United States is a “relatively low-income nation,” and that creates another obstacle to the success of the HSA, Salisbury says.

“Most HSAs essentially require the individual to come up with the money to put into the [account], and most Americans do not have the money they need in general,” Salisbury says.

For most individuals, Salisbury says, “HSAs have the ability to help structure a consumer-driven health plan but are unlikely to allow for substantial account buildup.”