![]() Nearly all of the private plans that are HDHPs with HSAs are employment-based plans, with a very small fraction being directly purchased on the individual market. In 2021, 37 percent of all privately insured adults aged 18 through 64 were enrolled in HDHPs, and slightly under half of those in HDHPs had HSAs. For 2023, this includes having an annual deductible of at least $1,500 for individuals and $3,000 for families, with a limit on out-of-pocket costs of no more than $7,500 for an individual and $15,000 for a family. Under current law, people can set up an HSA if they enroll in a high-deductible health plan (HDHP) that meets certain standards. Roughly 1 in 6 Privately Insured Adults Have HSAs Closing the coverage gap and making enhanced premium tax credits permanent would increase coverage and affordability for people with low and moderate incomes while also improving health equity. Policymakers should also pursue policies to increase affordability, including permanently extending enhanced premium tax credits that help people afford ACA marketplace plans. Instead of expanding HSAs, which primarily benefit high-income people who already have health coverage, policymakers should target federal resources toward people who are uninsured, particularly those who have low incomes - for example, by closing the Medicaid “coverage gap” in states that have refused to expand Medicaid under the Affordable Care Act (ACA). Instead of expanding HSAs, which primarily benefit high-income people who already have health coverage, policymakers should target federal resources toward people who are uninsured, particularly those who have low incomes. Meanwhile, HSAs already come at a steep cost to the federal government - estimated at $13 billion in 2022 and nearly $180 billion over the next ten years. ![]() ![]() The accounts often serve as lucrative tax shelters for people with high incomes while doing little to expand coverage and affordability. In reality, HSAs overwhelmingly benefit high-income people and exacerbate racial and ethnic inequities. Proposals to expand Health Savings Accounts (HSAs) often purport to help more people afford health coverage and health care, and proposed legislation in Congress would loosen restrictions on HSA contributions, withdrawals, and eligibility. ![]()
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