Study Casts Doubt on Whether HSAs Can Control Health Spending

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<p>Proponents of health savings accounts (HSAs) often argue that, when combined with high-deductible insurance plans, these arrangements can help control spiraling health care costs by forcing consumers to be more cost-conscious. Higher patient cost-sharing, they say, is the key.<br><br>But according to <a href="/cnlib/pub/enews_clickthrough.htm?enews_item_id=22988&return_url=http%3A%2F%2Fwww%2Ecmwf%2Eorg%2Fpublications%2Fpublications%5Fshow%2Ehtm%3Fdoc%5Fid%3D382001%26%23doc382001">a new Commonwealth Fund-supported study</a> in the July/August issue of <em>Health Affairs,</em> the tax subsidy associated with HSA/high-deductible health plans in the market today actually helps <em>reduce</em> out-of-pocket costs for people who spend the least and the most on health care, while increasing cost-sharing for those in the midrange of spending.<br><br>HSAs, which must be accompanied by a plan with a high deductible (at least $1,050 for an individual and $2,100 for a family), permit people to save money tax-free and use those funds, also tax-free, to pay their out-of-pocket health care expenses. Proponents of the HSA/high-deductible health plan combination say that increased out-of-pocket costs will encourage more prudent medical spending, leading to lower costs and greater efficiency in the health care system.<br><br>The authors of the new study, Dahlia Remler, Ph.D., and Sherry Glied, Ph.D., find that decreased cost-sharing is due to several factors, including HSAs' tax subsidies for out-of-pocket expenses and the fact that people with high deductibles can reach their plan's out-of-pocket maximum far more quickly than those in more comprehensive insurance plans.</p>