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I believe the President brought up that HSA benefit mostly those in upper income.

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LiberalFighter Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Feb-26-10 09:36 AM
Original message
I believe the President brought up that HSA benefit mostly those in upper income.
This study is 4 years old but I'm sure much has not changed since then. And it is a must read to help challenge those that argue in support.

GAO STUDY CONFIRMS HEALTH SAVINGS ACCOUNTS PRIMARILY BENEFIT HIGH-INCOME INDIVIDUALS <-links to the PDF document

Summary

A groundbreaking new study by the Government Accountability Office (GAO) demonstrates that Health Savings Accounts (HSAs) — tax-favored savings accounts attached to high-deductible health insurance plans established under the 2003 Medicare drug law — are heavily skewed toward affluent individuals. The GAO findings also provide strong indications that HSAs are being used extensively as tax shelters. Finally, the GAO data suggest that HSAs can be beneficial to healthy individuals with relatively few health care costs, but not to people who have medical conditions and incur higher costs.

Many health and tax policy analysts have warned in recent years that HSAs are likely to be used extensively as tax shelters by high-income individuals. The Administration and other HSA proponents have rejected such concerns and argued that HSAs are not disproportionately used by high-income households.

Until recently, though, little or no solid data have been available to assess whether HSAs are — or are not — being used disproportionately by affluent individuals. The primary data available have been on enrollment in HSA-eligible high-deductible plans in the small, individual health insurance market, which is skewed toward people at low and moderate income levels who cannot get employer-based coverage. Such data shed little light on HSA use in employer-based insurance,
where the vast bulk of Americans obtain their coverage.1 Moreover, such data do not appropriately distinguish between individuals enrolled in a HSA-eligible plan who are merely qualified to establish a HSA and the more limited number of individuals who have actually opened and are using HSAs.

Now, this has changed. An important GAO study issued earlier this month breaks new ground, by providing data from the Internal Revenue Service on who actually is using HSAs. The IRS data cover all Americans who made HSA contributions in 2004, regardless of whether they had individual or employer-based coverage.4 The GAO study also contains data, from three large employers who offer both HSA-eligible plans and traditional coverage, on how their employees have sorted themselves between HSA-eligible coverage and traditional insurance.

...
The principal findings in the GAO report include the following.
The Income of HSA Participants

• 51 percent of tax filers making HSA contributions in tax year 2004 (the first year HSAs were available) had adjusted gross income of $75,000 or more. This represents a decisive skewing toward higher-income individuals, since only 18 percent of all tax filers under age 65 had incomes of $75,000 or more in 2004.

• The average adjusted gross income of tax filers reporting HSA contributions in 2004 was $133,000, as compared to $51,000 for all tax filers under age 65 in 2004.

• In addition to making much greater use of HSAs, higher-income individuals also make larger tax-deductible contributions to HSAs. HSA participants who had incomes over $200,000 contributed an average of $3,010 in 2004. This was more than double the average contribution of $1,370 for HSA participants who had incomes below $50,000. This difference in average contribution levels further skews the tax benefits of HSAs to households that are high on the income scale.

The Income of HSA Participants

...
Indications of Use of HSAs as a Tax Shelter

...
HSAs and High Deductible Plans Reduce Costs for the Healthy, But Raise Them for the Less Healthy

...

...
Conclusion
Health and tax policy analysts long have warned that HSAs could be used extensively as tax shelters by high-income individuals. They have also expressed concerns that HSAs would be disproportionately attractive to healthier individuals and risk adverse selection. The GAO’s analysis of the IRS data, as well as its case studies of three large employers, lend strong credence to these concerns.
In its concluding observations, the GAO warns that “when individuals are given a choice between HSA-eligible and traditional plans — as in the individual market and with employers offering multiple health plans — HSA-eligible plans may attract healthier individuals who use less health care or, as we found, higher-income individuals with the means to pay higher deductibles and the desire to accrue tax-free savings.”

The GAO has thus effectively added its voice to the voices of health policy experts who have warned that HSAs may result in adverse selection, with healthier and less-healthy people separating into different insurance arrangements. If adverse selection becomes widespread, it is likely to pose serious risks to those Americans who are in poorer-than-average health, since the higher health care costs they must incur will no longer be pooled with the lower costs of individuals who are healthy. An increase in the number of Americans with below-average health who are uninsured or underinsured — or who receive adequate health insurance only by failing to meet other basic needs — would not be a desirable outcome for the nation.
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liberal N proud Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Feb-26-10 09:44 AM
Response to Original message
1. HSA's are not Health Insurance
And you have to have money to put into them in the first place.

Then you lose the money if you do not spend all of it in the calendar year.

The GOP wants to push this shit as reform and it is nothing more than a scheme for some rich company to get richer off the people.

Any ideas the GOP put forth need to be evaluated to see who is make the profit because that is their only goal. GREEDY BASTARDS.
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Arkansas Granny Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Feb-26-10 10:00 AM
Response to Reply #1
5. Since you have to have health insurance before you can have an HSA,
they don't do anything to help people without insurance coverage.


You must be covered by a High Deductible Health Plan (HDHP) to be able to take advantage of HSAs. An HDHP generally costs less than what traditional health care coverage costs, so the money that you save on insurance can therefore be put into the Health Savings Account.
http://www.ustreas.gov/offices/public-affairs/hsa/faq_basics.shtml

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subterranean Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Feb-26-10 11:55 AM
Response to Reply #1
9. Allow me to correct one of your points.
In a Health Savings Account, you do not lose the money if you don't spend it in the calendar year. It's your own money you're putting in, so any money you don't use for health care stays there and accumulates interest until you need it.

I think you're confusing HSAs with Flexible Spending Accounts, which do have a "use it or lose it" rule.
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CTyankee Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Feb-26-10 09:49 AM
Response to Original message
2. Glad there's this report, but geez, water is wet...
So, it's good to have this affirmation of something that common sense would tell you is true! I would just love to confront my puke friend who is on food stamps, has no health care, works for very little money, and ask her why she doesn't favor HSA's over real health care reform. After all, surely she can set aside enough money out of her bi-weekly paycheck to cover health care for herself and her 3 sons...:sarcasm:
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JoePhilly Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Feb-26-10 09:54 AM
Response to Reply #2
4. When you ask them that question .... also ask this ...
Are the going to full fund their IRA or 401k?

The limit, per individual, for 401k contributions is $16,000. So a 2 income couple can actually put away $32,000 this year.

So ... the GOP wants to kill social security, which would require to have a very strong retirement plan of 401k balance, and then they also want you to take MORE money out of your wages and stick them in an HSA.

So ask you friend if the have say $35,000 in wages that they can simply defer.
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CTyankee Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Feb-26-10 10:28 AM
Response to Reply #4
7. She can barely pay her monthly rent as it is!
This woman was nearly out on the street at one point. She told me that one of her friends had started to work as a prostitute on the side just to survive. I'm not kidding.

She would have been pretty desperate if it weren't for SS disability due to the fact that her children's father, from whom she was divorced, had an incurable disease and couldn't work, finally dying young (in his late 40s) because his health insurance did not cover the medication that would have saved his life. But her kids have aged out of that now.

When we talked about universal health care she said she "knew" someone from Ireland who came to the U.S. to get medication she couldn't get there. Sure, I thought, she had a "pre-existing condition" and just waltzed into the U.S. and got her meds...

There's gotta be a name for this kind of mental illness...oh wait, it's called "conservatism."
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JoePhilly Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Feb-26-10 11:16 AM
Response to Reply #7
8. I have to agree ...
The corporate shills in the GOP sell these folks false patriotism, they throw in some talk about God, maybe some false generalizations about the Constitution, and then get them to vote against their own best interests.

Its sad.

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CTyankee Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Feb-26-10 12:07 PM
Response to Reply #8
10. Her problem stems from the community she is from and still lives in.
She wouldn't vote for Obama because he called his grandmother a "typical white person." She said that was racist. She also refers to undocumented immigrants as "illegals." It's sometimes uncomfortable to be around her...
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4lbs Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Feb-26-10 12:18 PM
Response to Reply #2
11. I can't understand why anyone on food stamps would ever be a Republican. Repukes in Congress would
love to take away that "Socialist" food stamp program.
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CTyankee Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Feb-26-10 02:25 PM
Response to Reply #11
12. Perversely, they may have gotten themselves in a situation where they CAN'T take away
food stamps, because, as in the case with my friend, more people are ON food stamps and it includes white working class people who have fallen into poverty. If the repukes in Congress takes it away from these people, then they will have trouble...heh. They create a condition that impoverishes their own people and then try to to impoverish them further...lotsa luck.
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JoePhilly Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Feb-26-10 09:51 AM
Response to Original message
3. Exactly
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Overseas Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Feb-26-10 10:15 AM
Response to Original message
6. K&R . //nt
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