Even before Election Day, the 2016 presidential campaign season had a clear loser: anyone who was hoping the campaign would promote health savings accounts, flexible spending arrangements and other types of personal health accounts.
Hillary Clinton said nothing in favor of health savings accounts, but she also said nothing against them.
Donald Trump made expanding the health savings account program a major component of his proposals for replacing the Affordable Care Act.
Trump talks about the health savings account expansion idea on his campaign website, and he mentioned health savings account expansion briefly during campaign events. Earlier this month, he mentioned health savings account expansion during an appearance in Valley Forge, Pennsylvania, according to a transcript posted behind a paywall on the What the Folly? website.
“Our replacement plan includes health savings accounts, a nationwide insurance market where you can purchase across state lines, and letting states manage Medicaid dollars,” Trump said, according to the transcript.
This summer, Steve Christenson, an executive vice president at Brainerd, Minnesota-based Ascensus, said he was hoping the presidential campaign would give health savings accounts and other personal health account concepts much-needed publicity. He pointed to the many recent cases in which Democrats in the U.S. House joined with Republicans to support health savings account program improvement measures.
“Everyone has seen the value of the HSA,” Christenson said.
But, over the course of the campaign season, news organizations, and members of the public, focused mainly on issues such as immigration, the relationship of the United States with Russia and Mexico, and U.S. Supreme Court nomination preferences when looking at Clinton’s and Trump’s policy positions. Trump’s health savings account expansion proposal did not seem to capture the public imagination.
A Google Trends comparison shows, for example, that search activity for Trump and immigration spiked to 68 percent of the all-time peak level, from a base level of about 5 percent, in late August and early September, and that search activity for Trump and health jumped to 33 percent of the all-time peak level, from a base rate of about 10 percent, in mid-September. But search activity for “HSA” or for “Trump HSA,” never seemed to move in sync with campaign-related search activity.
Search activity for “Trump health” was a little stronger than activity for “Trump WikiLeaks” this summer, but activity for “Trump WikiLeaks” has been about three to four times as strong as “Trump health” activity since early October.
Search activity for health savings account soared to about 100 percent of the all-time peak level during the first week of November, but that increase appears to be the result of the start of the individual major medical open enrollment period for 2017, not the result of campaign publicity.
The health savings account program gives taxpayers who buy eligible health coverage with minimum deductibles a chance to put cash in a special fund without paying federal income taxes on the contribution. A taxpayer owns the account outright and can use withdrawals to pay for eligible products and services without paying income taxes on the withdrawals.
Some budget economists for both Democratic and Republican presidential administrations have suggested that specialized tax breaks often give the government and the country a relatively low level of benefits in exchange for the amount of tax revenue lost because the users of the tax breaks tend to be higher-income people who need less help in the first place.