Health Savings Accounts: A Conservative Benefit for the Wealthy

There is little evidence that health savings accounts are closing the health care affordability gap between working-class individuals and individuals with six-figure salaries and greater. The Government Accountability Office reports that "tax filers who reported [health savings account] activity in 2005 had higher incomes on average than other tax filers. Among tax filers between the ages of 19 and 64, the average [annual gross income] for filers reporting HSA activity was about $139,000 compared with about $57,000 for all other filers. The income differences existed across all age groups." In addition, there is evidence in the GAO report that because of the way health savings accounts are structured, they are serving as convenient tax shelters for the well-heeled. At the same time, lower-income people find that not only are they unable to afford to make a significant contribution to their accounts, they also are finding that many employers will not contribute to their accounts, as many employers contribute to health insurance premiums. Health savings accounts are not a substitute for a true plan to make health care available to all.