Study: Few high-deductible health plan members make HSA contributions

Few workers enrolled in high-deductible health plans are using health savings accounts to put money away to cover healthcare costs, according to a new study.

Researchers led by a team at the University of Michigan analyzed survey data from 1,637 people in an HDHP and found that about two-thirds were enrolled in a plan that includes an HSA. More than half (55%) had not contributed to the account in the past year.

High-deductible plans proliferated as employers sought ways to control rising health benefit costs, with enrollment in such plans increasing from 25.3% in 2010 to 40% in 2016. Health savings accounts are frequently paired with HDHPs to assist members in covering their health costs until they meet the deductible.

HDHP members without an HSA were most likely to select their plan through an exchange rather than gain coverage through their employer, according to the study, with 70% of people without such an account seeking coverage on an exchange.

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Common reasons for not contributing to an HSA included that the member had simply not considered it, cited by 36.8% of those who had not contributed.

In addition, 31.9% said they were unable to save for their health expenses.

The survey found that people who reported a high degree of insurance literacy were more likely to have made contributions in the past year, with 47.3% making a contribution. One in five people who contributed to their HSA also saved elsewhere for their care costs, and an additional 20% said they saved for healthcare solely in a non-HSA account.

This offers an opportunity for employers and insurers to provide greater outreach about the use of HSAs and the options available with their plans, the researchers said.

"As enrollment in HDHPs and policy interest in expanding use of HSAs both continue to grow, employers, health plans, and health systems should explore targeted interventions to encourage HSA uptake and contributions among individuals whose use of an HSA could potentially improve the affordability of needed health care services," they wrote.