January 2008 Census Shows 6.1 Million People Covered by HSA/High-Deductible Health Plans
America’s Health Insurance Plans (AHIP)
Center for Policy and Research
April 2008
The number of people with HSA/HDHP coverage rose to 6.1 million in January 2008, up from 4.5 million in January 2007, and 3.2 million in January 2006.
In two market segments — individual and large-group — over 90 percent of enrollees in HSA/HDHP plans were in Preferred Provider Organization (PPO) products.
Premiums for large-group coverage in HSA/HDHP plans were similar to those reported for small-group HSA/HDHP coverage. In both cases, these premiums are considerably lower than premiums reported in surveys of all employer-based coverage, including other types of plans. For example, the average premium was $12,106 in 2007 for all employer-sponsored family policies; nearly $4,000 higher than the reported average family premium for the best-selling small-group HSA/HDHP plan in January 2008, and almost $3,900 higher than the average premium for large-group HSA/HDHP plans.
Partial Information on Health Savings Accounts (based on information from 460,000–800,000 HSA acounts):
During the year 2007, 83 percent of the reported accounts in place had average annual balances of $2,500 or less; 7 percent had account balances over $5,000. (In general, health insurance plans offering HSA/HDHP coverage may not have information about HSA accounts held by their policyholders, especially if the HSA account is established with a bank that is not affiliated with the health insurance plan.)
Full report:
http://www.ahipresearch.org/pdfs/2008_HSA_Census.pdf
Press release:
http://www.ahip.org/content/pressrelease.aspx?docid=23159
Comment:
By Don McCanne, MD
Today’s press release from AHIP has the headline, “More Than Six Million Enrolled in Health Savings Account Plans.” In the release, AHIP President and CEO Karen Ignagni states, “Employers and individuals across the country and across the age spectrum are choosing HSA plans, which are now an important part of the portfolio of coverage options offered by health plans.”
So anyone who can read plain English now knows that the are more than six million health savings accounts. But wait a minute. This study shows only that there are more than six million high-deductible health plans (HDHPs) which meet the qualifications to establish a health savings account. They have only partial information on less than 800,000 actual health savings accounts and cannot tell us whether the other five million accounts were even established, much less funded.
This release is not about HSAs. It is about the industry’s high-deductible health plans. They are using the hype over HSAs to expand the market for their HDHPs by deceptively labeling them “HSA plans.”
Although the HSA label may be an effective marketing tool for these HDHPs, since only seven percent of the HSAs actually established and reported have balances over $5000, it is not really the HSA that ultimately motivates the individual or employer to purchase these plans. It is the low premium that is attractive to the purchaser.
HDHPs are less expensive because they require greater out-of-pocket spending by the patient, whether or not those funds come from the patient’s own health savings account. We are already experiencing a major epidemic of underinsurance, exposing patients to financial hardship. This deceptive marketing of HDHPs by the insurance industry will only compound this tragedy.
And our presidential candidates want to leave this industry in charge. The real tragedy would be if we merely sit back and let them do it.
