Author Archive

BREAKING: New Rules on HSAs

HHS has issued a “guidance bulletin” which states how they intend to define the minimum “actuarial value” that health plans must meet starting in 2014. If a plan does not meet the minimum actuarial value, it cannot be sold in the individual or small group markets. Many advocates of HSAs and other consumer-driven plans have hoped that HHS’ definition of “actuarial value” would not preclude HSA-qualified insurance plans from being offered in the new state insurance exchanges. The guidance bulletin is a mixed bag for HSAs. On the one hand, HHS says it will allow employers to include contributions they make to employees’ HSAs (and HRAs) when determining the actuarial value of the plans they offer. This will help high deductible plans that make people eligible for HSAs qualify as “Bronze” and “Silver” plans.

But the bulletin (and regulations to come) need to go further. More below the fold.

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HSA Survey

A survey conducted by America’s Health Insurance Plans (AHIP) is the largest of its kind. Here are the highlights:

  • The number of people with Health Savings Account (HSA)/High Deductible Health Plan (HDHP) coverage rose to 10 million in January 2010, up from 8 million in January 2009, and 6.1 million in January 2008.
  • Overall, enrollment in HSA/HDHP coverage in the group market rose to 8.0 million in January 2010, up from 6.2 million in January 2009.
  • Nearly 3 million lives were enrolled in HSA/HDHP coverage in the small-group market, and almost 5 million lives were covered in the large-group market.
  • Enrollment in the individual market rose to 2.1 million covered lives in January 2010, up from 1.8 million in January 2009.
  • HSA/HDHP plans accounted for 11 percent of all new health insurance purchases in January 2010.

Status of HSAs and Consumer-Driven Health Care in Health Reform

First and foremost, neither the House nor Senate health reform bills repeal HSAs. Earlier proposals that would have eliminated some of these options (particularly FSAs and HRAs) did not survive the legislative process. Below is a description of the remaining provisions that could be included in the final health reform legislation.

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Health Reform = More Cost Shifting

One of the biggest reasons health care costs are rising is because of the increasing shift of costs to private citizens because Medicare and Medicaid keep paying doctors and hospitals less and less. Reports last fall put the amount at almost $90 billion per year.

That dwarfs the extra we pay for "charity care," provided to uninsured patients. Unfortunately, this will likely get worse if more people are enrolled in Medicare and Medicaid in the future, which is what is being proposed on Capitol Hill.

Medicare Beneficiaries Spend 28% of Income on Health Care

Medicare beneficiaries spent an average of $4,394 of their own money on health care services in 2005-about 28% of income.

And this is the system single-payer advocates want ALL of us to be a part of?

Attack on HSAs

The U.S. Senate Committee on Finance has proposed new changes to Health Savings Accounts (HSAs) that could make them less attractive in the future. These options are only "proposed" so they are open for discussion.  Here's what you need to know about what these provisions would do to HSAs.

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Hatch Health Bill

The Family and Retirement Health Investment Act of 2008 (S.3626) has been introduced by Senator Orrin Hatch. The full text of the bill is here.

Here is a summary of what is in the bill:

Purchase of Any Health Insurance with HSA Funds Allowed. Allows anyone with funds in an HSA account to pay the premium for their HSA-qualified policies regardless of their circumstances. Under current law, people can only use their HSA account to pay for health insurance premiums when they are receiving federal or state unemployment benefits, or on a COBRA continuation policy from a former employer.

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HSA Webinar

HSA Consulting Services will host a surprisingly affordable webinar on the latest IRS guidance on Health Savings Accounts on Wednesday, July 23 at 12:00pm ET.  The webinar will last 90 minutes.  One can sign up for the webinar at any of the following websites:, and

Spanish Version of HSA Guide Now Available

I'm excited to announce that I have also just released a Spanish version of my HSA guide — Manual de sentido común Cuentas de Ahorros para la Salud — which is intended to help individuals and families for whom Spanish is their primary language to better understand Health Savings Accounts, how the HSA-qualified health plans that make people eligible for Health Savings Accounts compare to traditional health insurance, and how to determine whether a Health Savings Account is right for them.  The guide is a direct translation of my updated version in English, The Common Sense Guide to HSAs, released recently.  This guide should help Spanish-speaking family members and relatives feel more comfortable with the terminology and issues as well as advantages that HSAs present.

You may download a copy of the Spanish language guide for a fee at my website devoted to educating consumers about Health Savings Accounts.  The English version is also available for free on this site.

You may also be interested in signing up for a one hour HSA webinar I will be hosting on Wednesday, June 25th at 12:00 noon ET (11:00 am CT, 10:00 am MT, 9:00 am PT) to explain the new IRS guidance on IRA-to-HSA rollovers and account funding issues.  The webinar will provide an opportunity for Q&A as well.
The cost of the webinar will be $35.  To sign up visit For those that attend the webinar, the Spanish version of my guide book will be sent to you free of charge.