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Are HSAs Ready to Battle a Public Plan?

Les Masterson, for HealthLeaders Media, May 20, 2009

Another study released last week showed that the vast majority of HSA owners are satisfied with their accounts. OptumHealth Inc., a wellness company that serves 60 million people, handles nearly 400,000 HSAs, and is owned by UnitedHealth Group, reported that 91% of 500 HSA owners randomly surveyed nationally this year are happy with their accounts. Piggybacking on AHIP's claims that HSAs are not just for the wealthy, OptumHealth reported that 70% of those surveyed make $75,000 annually or less. OptumHealth also reported that HSAs are actually achieving their goal—making better healthcare consumers:

  • 64% of respondents said they inquired about generic options for medication.
  • 47% said they asked their providers about charges.
  • 83% said that people should research healthcare options to get the best price.
  • 72% of respondents said that individuals should be responsible for helping manage their own healthcare costs.

These two studies were released at the same time that the healthcare reform debate rages in DC. That's not a coincidence. Private health plans are rightfully viewing portions of healthcare reform as a direct assault on their business.

HSAs, the poster boys for creating better healthcare consumers and lowering healthcare costs under the Bush administration, are not seen by most Democrats as a solution—but rather a problem that prices the poor out of quality healthcare.

Democratic lawmakers, instead, are discussing a public insurance option, which they say would create a level playing field to compete against private insurers, and ultimately reduce healthcare costs.

Despite lawmakers being enamored by a public plan, health plan officials are still viewing HSAs and CDHPs as a cost-saving, patient-empowering movement, as was evident in the health plan portion of the HealthLeaders Media Industry Survey 2009.

Beyond the HealthLeaders Media results, employers are increasingly turning to HSAs as a way to control costs. Sure, HSAs are not likely to be part of healthcare reform, but as long as Congress keeps those accounts as an option for businesses and private plans, employers will remain interested in reducing costs through better consumerism and cost sharing.

Health insurers have made a number of concessions in hopes of derailing a public health plan, but HSAs could be a way for private plans to compete against a public plan because the savings accounts will help keep costs down and provide a distinct difference to a public plan with low administration costs.

Health insurers should review their HSAs, improve their consumerism tools, and prepare for potential battle against a public plan.


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Les Masterson is an editor for HealthLeaders Media.

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