7 Reasons Why Health Savings Accounts are No Solution for the Health Care Crisis

by Judy Waxman, Vice President for Health and Reproductive Rights
National Women’s Law Center

This post is part of a daily series for National Women's Health Week and a weekly series on Women and Health Reform.

Comprehensive and affordable health coverage gives women access to the health care that is vital to their well-being. But this coverage is out of reach for far too many women and their families - that’s why we need real health reform that will help women and their families get the health care they need. 

Yesterday, I testified before Congress on why so-called “consumer-driven health care” and Health Savings Accounts do not qualify as the comprehensive and affordable health coverage we need in health reform. Health Savings Accounts (HSAs) are tax-sheltered accounts for individuals enrolled in high-deductible health plans (HDHPs), and proponents of these consumer-driven arrangements state that they encourage saving for future health care expenses and allow consumers more control over health care choices. In my testimony, I laid out seven reasons why consumer-driven health care is a short-sighted remedy that fails to address the real obstacles to health care for Americans, especially lower-income women:

1. Consumer-driven health plans require a level of cost-sharing (through deductibles, coinsurance, and copayments) that is not affordable for lower-income women.
2. Lower-income women cannot afford to fund their HSAs, and their employers may not do it either.
3. Lower-income women will not benefit from the tax advantages of HSAs.
4. Consumer-driven health plan premiums are often higher for women than for men in the individual health insurance market.
5. Women, who are likelier to have greater-than-average health care needs, are therefore at greater financial risk under a consumer-driven health plan.
6. Consumer-driven health care provides an incentive for women to use less cost-effective and preventive care, such as prescription contraceptives.
7. Women who need pregnancy-related care will face significant challenges under a consumer-driven health care model.

Too many women already face serious challenges in getting necessary health care. We must change the health system in ways that will benefit women, not make their situation worse. National Women’s Health Week is the perfect time to take a closer look at what women need to stay healthy and what consumer-driven health care really means for women.  It’s plain and clear that this reform strategy just won’t provide women with the comprehensive and affordable coverage that they need.