Value Of HSAs Debated During House Hearing

The president of America’s Health Insurance Plans outlined a series of “common sense policy recommendations” to expand access to health savings accounts during a House hearing held on June 28 to assess the current status of the program, which found supporters and critics divided along the usual fault lines.

Specifically, in contrast to the call by Karen Ignagni, president of AHIP, Washington, for expansion of the program, one critic of HSAs used the hearing to say that the product is “a misguided solution for reining in U.S. health care costs.”

The hearing before the House Ways and Means Committee was convened by panel Chairman Bill Thomas, R-Calif., not only as a means of assessing the current status of the program but also to determine the committee’s future consideration of HSA adjustments.

However, in general, Democratic members of the committee voiced continued skepticism of HSAs as even a factor in resolving health insurance problems of cost and the number of uninsured, while Republican members of the committee touted HSAs as the market providing a real-world solution to the problem.

Ignagni said that HSA-eligible, high-deductible health plans “have quickly become valued health coverage options for consumers and employers,” and she urged Congress to take the lead in facilitating the next generation of HSAs.

“HSAs are helping a substantial number of previously uninsured consumers purchase coverage, accumulate savings for their future medical needs and access preventive care services. HSAs also are enabling many small employers to offer health coverage to their employees for the first time,” Ignagni said.

But Sara Collins, Ph.D., assistant vice president of the Commonwealth Fund’s Future of Health Insurance unit, argued that “increasing patient cost-sharing is a misguided solution for reining in U.S. health care costs.”

Collins said there is no evidence backing the claim that Americans spend too much on health care because they are protected from its real cost–one of the principal justifications put forth by those promoting HSAs coupled with high-deductible health plans.

“Americans already pay far more out of pocket for their health care than citizens do in any other industrialized country,” she noted. Moreover, studies show that high out-of-pocket costs lead patients to decide against getting the health care they need.

“The major beneficiaries of the tax savings available through HSAs are likely to be healthier and more affluent taxpayers who already have health coverage–and can afford the financial risk posed by higher-deductible plans,” she said.