Last year, for the first time, a handful of school districts adopted Health Savings Account (HSA) plans for employees. While some members say it's too soon to pass judgment and are taking a wait-and-see approach to their effectiveness, CTA's Health Benefits Task Force Chair Bob Nichols says CTA is not recommending that members go down that road: "HSAs offer a way to help you pay for health costs, not a way of insuring you against such costs."
Established as part of President Bush's Medicare Prescription Drug, Improvement and Modernization Act of 2003, HSA's inherent structure favors the wealthy and healthy. It's a "tax-preferred savings account" that offers tax benefits for anyone purchasing an insurance policy with a high deductible of at least $1,000 for an individual and $2,000 for a family.
"Health savings accounts coupled with high-deductible health plans have potential pitfalls, especially for families with low incomes or individuals with chronic health conditions, who are at greater risk of accruing burdensome medical debts and facing barriers to needed health care," says Commonwealth Fund President Karen Davis.
Half of insured adults with a high-deductible health plan have medical bill problems or debts, compared with less than a third of those with lower-deductible plans, she says. Individuals with high deductible plans are also more likely than those with lower-deductible plans to decide to skip a medical test, or forgo treatment and follow-up due to cost.
"The premise is that people will make more consumer-conscious decisions under this type of plan," says CTA Negotiations and Organization Specialist Jim Schlotz." But this isn't going to happen; people will have decreased quality of care instead."
HSAs shift the balance of power from consumers to insurers. "With HSAs, consumers remain isolated and weak, with no bargaining power to deal with providers on quality and price."
