Growth in HSA plan enrollment slows

In 2017, the top annual out-of-pocket spending maximum for an individual account holder is $6,550. (Image: iStock)

More AHIP HSA data

In other survey results, AHIP found that:

• • • • Only 1.9 million of the HSA-compatible coverage users had individual or family policies.

      • Only 11 percent of the enrollees in HSA-compatible coverage are in the 25-44 age group, and 35 percent are in the 45-64 age group.

      • Seventy-five percent of the participating insurers provide some kind of health care cost information online.

To be compatible with the HSA program, health coverage must make the patient responsible for a lot of medical bills, but not too much. For an individual in 2017, the minimum deductible is $1,300. But the top amount an HSA-compatible plan can require a patient to spend on in-network, covered care is $6,550. 

The Affordable Care Act major medical rule architects and implementers had mixed feelings about use of HSAs and high-deductible coverage. Some liked the idea of using relatively high out-of-pocket spending requirements to give patients ”skin in the game,” and encourage patients to hold down spending. Other Democrats suggested that high out-of-pocket spending costs might hurt patients’ access to care.

Top Trump administration health agency officials have expressed similar mixed feelings about high-deductible health coverage.

Trump included the idea of expanding the HSA program as a major part of his health policy proposal package when he was running for president.

Dr. Tom Price, Trump’s new Health and Human Services secretary, frequently called for expanding the HSA program when he was serving the House. But Price, an orthopedic surgeon, said during a Senate confirmation hearing that he believes high deductibles are keeping some patients from getting the care they really need.

For insurers operating under Affordable Care Act individual major medical rules, one problem is that the rules have pushed the deductibles for the cheapest individual major medical policies over $6,000. In some markets, the deductibles for the cheapest individual policies are too high for the policies to be HSA-compatible.

Correction: An earlier version of this story described AHIP’s interpretation of its HSA-compatible plan activity data incorrectly. AHIP analysts believe the drop in the number of participating insurers is the result of a survey response issue, not a drop in insurer activity in the HSA-compatible plan market.

Related:

D.C. exchange to set HSA-compatible plan mandate

EBRI posts 2015 health savings account data

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