Making Health Savings Accounts Work

One of the health care policies that President-Elect Trump has advocated is an expansion of Health Savings Accounts, or HSAs. Research suggests that HSAs, as they currently exist, primarily benefit wealthier and healthier individuals. What would it take for HSAs to be more equitable, effective and efficient? Over on the Health Affairs blog, our friend Kathryn Philips of the University of California, San Francisco, explores this question.

Kathryn notes that consumer-oriented reforms — like HSAs, health care price transparency and others — have an important role in improving our health care system. There are demonstrated benefits of HSAs. However, these benefits are not applied equally across the public. In particular, low-income individuals are least likely to benefit from HSAs.

Moreover, Kathryn notes an “often neglected aspect of HSAs”:

[T]hey require an educated and savvy consumer who can devote a great deal of time and effort to understanding their plan and shopping for care. I can speak to this from my own experience. I wanted to “practice what I preach” and thus enrolled in a high-deductible health plan coupled with a HSA. How can I shop for care when providers can’t tell me what the price is or they tell me that care is “free” simply because I don’t pay a co-pay up-front? How can I choose between services and providers when I don’t have enough information to do so? How can I navigate through multiple, often contradictory and unlinked websites — one for the health plan, one for carve-out benefits, and one for my HSA? And how can I even remember when to pay for care using my HSA debit card versus asking the provider to bill the plan? In sum, does my HSA cause me to shop more for care? Yes. Does it enhance my pocketbook? Sometimes. Does it improve my health? I’m not sure.

Kathryn also draws upon the study she published together with Public Agenda in Health Affairs last spring, noting that the use of behavioral economics can create more effective policies.

Read Kathryn’s full post over at Health Affairs. And click here for more on our work regarding consumer-oriented health reform.

This piece was first published on the Public Agenda blog.