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AHIP: Health Savings Account Enrollment Reaches 8 Million

John Commins, for HealthLeaders Media, May 13, 2009

Eight million Americans are covered by health savings account-eligible insurance plans, an increase of nearly 2 million people since last year, according to the industry trade group America's Health Insurance Plans.

As part of its ongoing effort to defend HSAs from accusations that they are merely tax havens for the wealthy, AHIP released another report today that claims that HSA account holders have a broad range of incomes across the country.

That study, Estimated Income Characteristics of HSA Accountholders in 2008, claims that 49% of accountholders live in neighborhoods with median incomes under $50,000, and that the average total deposits for all HSA accounts were $1,634, while the average total withdrawals were $1,063.

"HSA plans provide coverage to a number of consumers of all ages and incomes across the country," says Karen Ignagni, president and CEO of AHIP. "They represent an important choice for employers and individuals when looking at the portfolio of coverage options available."

A Government Accountability Office report in May 2008 found that the average adjusted gross income of taxpayers with HSAs was $139,000 in 2005, compared with an average of $57,000 for all other filers. Critics have used those GAO figures to contend that HSAs–created under the Bush Administration–are tax shelters for wealthy Americans, rather than a means to access affordable health insurance.

The use of HSAs by lower-income Americans also has been criticized because of concerns that they can't afford upfront costs associated with high-deductable plans. The GAO says more than 40% of HSA-eligible people with high-deductible health plans say they don't have HSAs because they don't understand how the plans work, say the plans are too expensive, or don't think they need them.

The AHIP survey found that:

  • Approximately 1.9 million Americans have enrolled in an HSA plan since January 2008. Previous AHIP census reports found that 6.1 million were enrolled in January 2008, 4.5 million were enrolled in January 2007, 3.2 million were enrolled in January 2006, and 1 million were enrolled in March 2005.

  • 30% of individuals covered by an HSA plan were in the small group market, 47% were in the large-group market, and 23% were in the individual market.

  • 83% of HSA enrollees are covered by PPOs, and 10% are covered by HMOs. For individual coverage, almost 92% of HSA enrollees were in PPOs, while 85% of large-group enrollees, and 76% small group enrollees were in PPOs.

  • States with the highest levels of HSA/HDHP enrollment were California (854,000), Florida (524,000), Illinois (497,000), Texas (476,000), Ohio (464,000), and Minnesota (388,000).


John Commins is a senior editor with HealthLeaders Media.

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