Lawmakers in a House Ways and Means health subcommittee hearing on Wednesday looked at ways to expand use of health savings accounts, but Democrats were skeptical that new policies would address the escalating costs that patients face.
While Congress is posing a broader push to address soaring healthcare costs. Democrats questioned whether HSAs are a viable solution. The White House pushed for laxer HSA rules as a potential trade-off for an individual market stabilization package earlier this year and the accounts were also a key part of the GOP's failed legislation to repeal and replace Obamacare.
Rep. Mike Thompson (D-Calif.) questioned whether potential HSA changes, such as lifting contribution limits and expanding the services the dollars can pay for, could provide "meaningful relief" from healthcare bills.
Rep. Brian Higgins (D-N.Y.) suggested the accounts encourage insurers to offer unaffordable coverage.
"HSAs don't do anything to relieve prices," Higgins said. "Insurance companies had every opportunity to offer good insurance products, but they didn't want to."
Industry witnesses representing employers and insurers urged lawmakers to expand options for so-called consumer-directed plans that pair HSAs with high-deductible coverage—which have seen significant growth within the employer market largely for people at median income.
They argued that if employees can add more money to their accounts and use the dollars to pay for more services they can better manage big health expenses.
But one witness pushed back. Sherry Glied, dean and professor of public service at New York University, argued that greater tax benefits for people with HSAs wouldn't affect the people who need the most help because they already have a relatively low tax rate.
High prices within the health system contribute far more to the overall costliness to the government and patients than utilization, Glied said. Pushing more people into high-deductible plans isn't likely to bring down those prices.
"You should encourage high-deductible plans to lower their deductibles and provide access," Glied told lawmakers. "Putting that on the HSAs is not going to help solve this problem. The cost of the plan should be a function of what they use, not whether they are paying for it out of an HSA."
