I’ve spent a lot of blog space recently talking about the benefits and features of a new type of health care insurance, the HSA-high deductible combination. For those who just came on board, an HSA, or health savings account, enables employees to pay for their share of health care with pretax dollars and is offered in conjunction with a low premium, high deductible healthcare insurance policy. Employees can save money in the HSA tax-free and draw out funds anytime they want to pay for the premium, deductibles, co-pays or other medial costs. Employees don’t have to spend what they put into an HSA by the end of the year.
But do people like the HSA?
A 2009 study by OptumHealth shows that once employees open an HSA they are delighted with the coverage. In the study, 82% of the respondents—all HSA owners—said that they are fully satisfied with the plan, while 78% believe that the HSA option should remain a health care option no matter what happens in future health care reform.
America’s Health Insurance Plans (AHIP), the trade association of health care insurers, surveys how many people are covered by HSA-high deductible plans once a year. Recent AHIP figures demonstrate that in the past two years, the number of people enrolled in HSA plans has grown by 90% and now stands at 6.1 million nationally, broken down as follows:
- Small groups: 1.8 million
- Large groups: 2.8 million
- Individuals: 1.5 million
Among these 6.1 million are large numbers of people who did not have health insurance before establishing an HSA and taking a high deductible plan. A 2007 AHIP study found that 27% of people with HSAs in employer-based plans were previously uninsured. A study by Golden Rule Insurance, a UnitedHealth Group company, found that an even larger percentage of individual-based HSA buyers—a whopping 40%—were previously uninsured. Based on these two studies, OptumHealth Financial Services estimates that nearly 2.5 million previously uninsured people have gained coverage through HSA plans through January of 2008. And a 2009 OptumHealth survey estimates that 3 in 10 holders of HSA plans say that if it weren’t for the HSA option, they wouldn’t have health care insurance at all.
The HSA-high deductible combination has been particularly popular with two groups that insurance carriers and brokers have had difficulty serving in the past: small businesses and employees with relatively low incomes. We find that among UnitedHealthcare participants, 74% of all small businesses now select the HSA-high deductible option, as do 64% of all employees earning less than $25,000 per year.
So yes, people like the HSA, and with reason: it saves money and if it’s structured right, also helps to improve the quality of care people receive.