Policy Examples

• HSAs are not prevalent on the individual market potentially due to several conflicting Internal Revenue Service (IRS) and Affordable Care Act (ACA) policies. For example, ACA out-of-pocket limits may be higher than IRS limits and the ACA’s cost-sharing reductions may make a deductible below the IRS requirement to allow an HSA. Source
• Once an individual becomes eligible for Medicare, they may no longer contribute to their HSA, however, remaining HSA funds may be used for a broader set of health care expenses. HSA funds can be used to pay Medicare Parts A, B, and D premiums, as well as premiums for Medicare Advantage. Source
• A Medicare Medical Savings Account (MSA) plan is a type of Medicare Advantage plan that combines a high-deductible health plan with a medical savings account. Enrollees of Medicare MSA plans can initially use their savings account to help pay for health care, and then will have coverage through a high-deductible insurance plan once they reach their deductible. source

Outcome Evidence

• In 2018, the Society for Human Resource Management reported more than half of all employers (56%) offer an HSA, showing a more than 12% growth since 2013. On top of those who offer HSAs, 37% of employers reported they are contributing to employee HSAs, a 5% increase since 2014. source
• According to a 2018 study from the Evidence Based Research Institute, consumers are not fully informed on how an HSA functions and are subsequently missing out on key benefits. source
• According to a 2015 Merrill Lynch Bank of America report, only 11% of employees were able to successfully identify key attributes of HSAs. source