7 reasons HSAs are taking off

And consumers involved in CDHPs and HSAs are not just engaged, they are (for the most part) satisfied — one more draw for HSAs.

New research from EBRI found satisfaction levels are rising for Americans with consumer-driven health plans, just as they are slipping for traditional health plans.

Long-term, consumer involvement might be the most important shift to health care. Bart Halling, vice president of customer solutions for UMR, the third-party unit of UnitedHealthCare, says bringing consumers to the forefront of their care is vital to making the country’s health care system work.

“Although it would be hard to make the case that consumerism in itself can be the single silver bullet to all that ails the industry, it’s easier to imagine the industry collapsing in on itself from the weight of unchecked cost trend growth, without the positive influence of consumerism,” he says.

Tax savings

Two words (or technically, a one-word hyphenate) can describe why HSAs are becoming increasingly popular: Tax-exempt.

“This is a no-brainer. HSAs, HRAs and other tax-advantaged accounts are just that: tax-advantaged,” says Jody Dietel, chief compliance officer at WageWorks Inc. and executive director of Save Flexible Spending Plans, an advocacy campaign to protect the accessibility and use of flexible spending accounts.

“Employees keep more of their money; employers keep more of their money. It’s a win-win,” she says.

“Health savings accounts provide a tremendous opportunity for American employees to take better control of their health care spending while also benefitting from the tax advantages afforded by the accounts,” adds William Applegate, vice president at Fidelity Investments in Boston. “The special tax advantages of these accounts allow employees to accumulate funds over their working life and withdraw funds tax-free for qualified medical expenses in retirement.”

Unlike with a flexible spending account, consumers don’t have to use the money by the end of the year — it can grow tax-deferred in your account for later use. There’s no deadline for making a withdrawal: Consumers can reimburse themselves in future years for medical costs incurred now.

Consumers also can use tax-free HSA money to reimburse themselves for the money that Social Security withholds from their benefits to pay for Medicare Part B, and they can use HSA funds to pay Part D or Medicare Advantage premiums, or for a portion of long-term-care insurance premiums.

Patient Protection and Affordable Care Act 

The Patient Protection and Affordable Care Act obviously is changing all aspects of health care — and HSAs are no exception.

The law has a number of effects on HSAs. For starters, PPACA bans the use of HSA funds for over-the-counter medications without a prescription.

But despite initial concerns over how PPACA could cripple HSAs, the law actually is spurring more interest in these types of plans, industry insiders say. PPACA naysayers suggest that health spending will increase under PPACA. As carriers warn of rising premiums under PPACA, many industry insiders see HSAs as an affordable solution.

“If employers didn’t think they had any responsibility to provide health care, they do now,” says Dennis Triplett, CEO of UMB Healthcare Services, in Kansas City, Mo. ”Now, they’re thinking ‘what are the best plans for my employees?’ And a lot of them are deciding it’s a HDHP/HSA.”

Large employers on board

Large employers are now on board with HSAs—and it’s making a huge difference in the overall numbers.

The first group that jumped on the bandwagon for HSAs were individuals, explains Triplett says.

Then smaller employers became involved, and now — finally — large employers are becoming interested in the savings accounts. And they’re making the trend really boom.

See also: Health Accounts: Witnesses Clash on Value of FSAs, HSAs

“We’re seeing a lot of growth in the large employer market, and that will be the driving segment in the next several years,” Triplett says. And large employers obviously have a very large number of employees who will then adopt the accounts.

“The larger groups are trying it and they’re seeing it works,” he says.

A recent survey from the National Business Group on Health found that the number of employers that are offering only a CDHP to employees continues to rise, with 22 percent planning to implement a total replacement CDHP next year, up from 19 percent this year.

Big savings

Most important, as far as Severino is concerned, HSAs are growing because people are seeing an impact on their bottom line.

“HSAs are becoming mainstream because the high deductible plan they’re tied to typically offer a lower insurance premium for employers, employees and consumers,” he says. “Right now, most buying decisions are based on cost, and the high-deductible plans are the common leaders for lowering costs.”

Triplett agrees.

“Of course employer savings may vary state to state, but by and large, the savings are there,” Triplett says. “The economy isn’t as vibrant as many of us would like, so a lot of us are focused on saving money and being more efficient in their operations. A lot of [employers] are looking at benefits packages and seeing that’s one area where they can save money.”

According to Towers Watson, companies in which 50 percent or more of workers have health savings accounts and other consumer-directed benefits report total costs per employee that are more than $1,000 lower than companies without these types of health plans.