|Leading policy-makers and scholars explain how market forces, deregulation, and consumer choice can work to improve health care for all Americans.||
Congress Got Something Right
While is Congress is fretting over the complexity of the Medicare drug benefit, there is at least one program, Dr. Gratzer says, that they should take unabashed credit for: Health Savings Accounts.
When Congress passed the HSA-enabling legislation [in 2003], many foresaw disaster, claiming that the insurance was for the healthy and the wealthy and would do little to help those without coverage. But early data suggest otherwise. An online insurance brokerage, eHealthInsurance, reports that nearly half of its HSA customers earn less than $50,000 a year. A full 70% pay under $100 a month for the coverage. A third were previously uninsured (perhaps not surprising given the insurance's low cost). Assurant Health, a large insurer, notes that many new HSA purchasers are over 40, often with chronic health problems.
Let's be clear: There have been plenty of growing pains. In California, legislators have yet to pass amendments to current law that would allow individuals to deduct HSA contributions. In New York, Massachusetts and a handful of other over-regulated states, HSA products are absent from the individual insurance market.
But HSAs are quietly gaining popularity. Perhaps most importantly, they are changing the way Americans think about their health care; empowered with health dollars, people are becoming more cost conscious. As a result, many insurance companies aren't just selling HSAs -- they're offering companion services, like information Web sites.
Grazter concludes, however, that much more can be done to make HSA’s successful, including allowing tax deductibility for health insurance premiums (which would give HSA’s parity with employer-purchased health care) and allowing consumers to shop for insurance in national markets. Both of these reforms would build on HSA’s initial success, and help to make health insurance more affordable for all Americans.
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