Health Savings Accounts: Participation Grew, and Many
HSA-Eligible Plan Enrollees Did Not Open HSAs while Individuals
Who Did Had Higher Incomes (14-MAY-08, GAO-08-802T).
With health care spending increasing, Congress enacted
legislation effective in 2004 establishing Health Savings
Accounts (HSA) to be coupled with eligible high-deductible health
plans. The novel structure of eligible health plans coupled with
HSAs has raised questions about who selects them and how they are
used. Proponents contend that the lower premiums of the health
plans and the tax-free savings potential of HSAs appeal to
consumers, while the health plans' high deductibles encourage
enrollees to be more astute health care consumers. However,
critics are concerned that HSA-eligible plans may attract
enrollees who seek lower premiums but lack the resources to
contribute to an HSA, and wealthy enrollees who may use the HSA
primarily to accumulate tax-advantaged savings. This statement
focuses on (1) participation in HSA-eligible high-deductible
health plans and HSAs, (2) the income characteristics of HSA
account holders, and (3) the funding and use of HSAs. This
statement is based primarily on findings from GAO's April 2008
report entitled Health Savings Accounts: Participation Increased
and Was More Common among Individuals with Higher Incomes
(GAO-08-474R). For that report GAO reviewed industry data on the
participation in HSA-eligible plans and HSAs, and analyzed
Internal Revenue Service (IRS) data on tax filers who claimed
deductions for HSAs. The statement also draws on findings from
related GAO reports issued in 2006.
-------------------------Indexing Terms-------------------------
REPORTNUM: GAO-08-802T
ACCNO: A82109
TITLE: Health Savings Accounts: Participation Grew, and Many
HSA-Eligible Plan Enrollees Did Not Open HSAs while Individuals
Who Did Had Higher Incomes
DATE: 05/14/2008
SUBJECT: Cost analysis
Cost control
Cost effectiveness analysis
Deductibles and Coinsurance
Eligibility determinations
Flexible spending accounts
Funds management
Health care cost control
Health care costs
Health care planning
Health care policies
Health care programs
Health care services
Health insurance
Income statistics
Medical expense claims
Program evaluation
Program management
Strategic planning
Surveys
Cost estimates
Program goals or objectives
Health Savings Accounts
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GAO-08-802T
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Testimony:
Before the Subcommittee on Health, Committee on Ways and Means, House
of Representatives:
United States Government Accountability Office:
GAO:
For Release on Delivery:
Expected at 10:30 a.m. EDT:
Wednesday, May 14, 2008:
Health Savings Accounts:
Participation Grew, and Many HSA-Eligible Plan Enrollees Did Not Open
HSAs while Individuals Who Did Had Higher Incomes:
Statement of John E. Dicken:
Director, Health Care:
GAO-08-802T:
GAO Highlights:
Highlights of GAO-08-802T, a testimony before the Subcommittee on
Health, Committee on Ways and Means, House of Representatives.
Why GAO Did This Study:
With health care spending increasing, Congress enacted legislation
effective in 2004 establishing Health Savings Accounts (HSA) to be
coupled with eligible high-deductible health plans. The novel structure
of eligible health plans coupled with HSAs has raised questions about
who selects them and how they are used. Proponents contend that the
lower premiums of the health plans and the tax-free savings potential
of HSAs appeal to consumers, while the health plans� high deductibles
encourage enrollees to be more astute health care consumers. However,
critics are concerned that HSA-eligible plans may attract enrollees who
seek lower premiums but lack the resources to contribute to an HSA, and
wealthy enrollees who may use the HSA primarily to accumulate tax-
advantaged savings.
This statement focuses on (1) participation in HSA-eligible high-
deductible health plans and HSAs, (2) the income characteristics of HSA
account holders, and (3) the funding and use of HSAs. This statement is
based primarily on findings from GAO�s April 2008 report entitled
Health Savings Accounts: Participation Increased and Was More Common
among Individuals with Higher Incomes (GAO-08-474R). For that report
GAO reviewed industry data on the participation in HSA-eligible plans
and HSAs, and analyzed Internal Revenue Service (IRS) data on tax
filers who claimed deductions for HSAs. The statement also draws on
findings from related GAO reports issued in 2006.
What GAO Found:
GAO found that the number of individuals participating in HSA-eligible
high-deductible health plans and HSAs increased significantly since
2004. A series of health insurance carrier surveys reported that the
number of lives covered by HSA-eligible plans increased significantly
from about 438,000 in September 2004 to an estimated 6.1 million in
January 2008. GAO�s analysis of IRS data showed that the number of tax
filers ages 19 to 64 reporting HSA activity nearly tripled from about
120,000 in 2004 to about 355,000 in 2005. Industry estimates indicated
continued growth in HSA participation in 2006 and 2007. However, many
HSA-eligible plan enrollees did not open an HSA. From 2005 through
2007, 42 percent to 49 percent of HSA-eligible plan enrollees reported
that they had not opened an HSA, and 20 percent to 24 percent did not
plan to open an HSA, citing their inability to afford an HSA or a
belief they did not need an account.
Tax filers who reported HSA activity and enrollees in certain HSA-
eligible plans had higher incomes on average than other tax filers. For
example, among tax filers between the ages of 19 and 64, the average
adjusted gross income (AGI) for those reporting HSA activity in 2005
was about $139,000, compared with about $57,000 for other filers. About
59 percent of HSA filers had AGIs of $60,000 or more, compared with 26
percent of other tax filers. Moreover, income differences between HSA
and other filers existed across all age groups and within different tax
filing statuses, such as single or joint tax filers.
Among all filers reporting HSA activity in 2005, average
contributions�reflecting both individual and employer contributions�
were about $2,100, compared to average withdrawals of about $1,000.
Among filers who reported HSA contributions in 2005, about 41 percent
did not withdraw any HSA funds that year, while about 22 percent
withdrew as much or more than their reported contributions. About 93
percent of reported withdrawals were claimed for qualified medical
expenses. Some HSA-eligible plan enrollees GAO interviewed for a 2006
report were unsure what medical expenses qualified for payment using
their HSAs, and few researched the cost of services before obtaining
care.
To view the full product, including the scope and methodology, click on
[hyperlink, http://www.gao.gov/cgi-bin/getrpt?GAO-08-802T]. For more
information, contact John E. Dicken at (202) 512-7114 or
[email protected].
[End of section]
Mr. Chairman and Members of the Subcommittee:
I am pleased to be here today as you examine issues related to tax
advantaged health savings accounts (HSA) and HSA-eligible high-
deductible health plans. With health care spending increasing in the
United States, Congress enacted legislation effective in 2004
establishing HSAs to be coupled with HSA-eligible high-deductible
health plans.[Footnote 1] The novel structure of HSA-eligible plans
coupled with HSAs--a type of consumer directed health plan[Footnote 2]-
-has raised questions about who selects them and how they use the
accounts. Proponents of consumer-directed health plans contend that the
lower premiums of HSA-eligible plans and the tax-free savings potential
of HSAs appeal to many consumers, while the high deductibles encourage
them to be more astute health care consumers.[Footnote 3] However, some
critics are concerned that HSA-eligible plans may attract enrollees who
seek lower premiums but lack the resources to contribute to an HSA, and
wealthy enrollees who may seek to use the HSA primarily to accumulate
tax-advantaged savings rather than pay for medical expenses.
My comments today are based primarily on findings from our April 2008
report entitled Health Savings Accounts: Participation Increased and
Was More Common among Individuals with Higher Incomes.[Footnote 4] My
remarks focus on (1) participation in HSA-eligible high-deductible
health plans and HSAs, (2) the income characteristics of HSA account
holders, and (3) the funding and use of HSAs.
In conducting our work for the April 2008 report, we analyzed industry
data, Internal Revenue Service (IRS) data, and nationally
representative survey data. To examine participation in HSA-eligible
health plans we obtained estimates of the number of lives covered by
HSA-eligible health plans from 2004 to 2007 from America's Health
Insurance Plans (AHIP).[Footnote 5] For this statement we updated this
information to 2008 based on AHIP's more recent estimates. To examine
participation in HSAs, we analyzed 2004 and 2005 tax filer data from
the IRS Statistics of Income (SOI) sample to estimate the number of tax
filers reporting HSA activity in those years,[Footnote 6] reviewed
various estimates of the number of HSAs in 2006 and 2007 that were
reported in health care and financial industry publications,[Footnote
7] and examined data from nationally representative surveys of HSA-
eligible plan enrollees conducted from 2005 to 2007.[Footnote 8] To
examine income characteristics of HSA account holders, we analyzed IRS
tax data from the 2005 SOI sample. To examine funding and use of HSAs,
we analyzed IRS tax data from the 2005 SOI sample and data from
nationally representative employer surveys conducted from 2005 through
2007.[Footnote 9] We performed this work from September 2007 through
February 2008, and a detailed explanation of our scope and methodology
is included in the report. I will also draw on findings from our
related reports issued in 2006.[Footnote 10] We conducted all our work
in accordance with generally accepted government auditing standards.
Those standards require that we plan and perform the audit to obtain
sufficient, appropriate evidence to provide a reasonable basis for our
findings and conclusions based on our audit objectives. We believe that
the evidence obtained provides a reasonable basis for our findings and
conclusions based on our audit objectives.
In summary, we found that the number of individuals participating in
HSA-eligible health plans and HSAs increased significantly since 2004;
however, HSA-eligible health plans still represented a small share
(about 2 percent in 2006) of individuals with private health coverage.
While participation in both the eligible health plans and the HSAs
grew, survey estimates indicate that more than 40 percent of the health
plan enrollees did not open an HSA, citing among other reasons their
inability to afford an HSA or a belief that the accounts were not
needed. Tax filers who reported HSA activity in 2005 had higher incomes
on average than other tax filers--about $139,000 compared with about
$57,000. Among all filers reporting HSA activity in 2005, average
contributions--reflecting both individual and employer contributions--
were about $2,100, compared to average withdrawals of about $1,000.
Among filers who reported HSA contributions in 2005, about 41 percent
did not withdraw any HSA funds that year, while about 22 percent
withdrew as much or more than their reported contributions. About 93
percent of reported withdrawals were claimed for qualified medical
expenses. We reported in 2006 that some HSA-eligible plan enrollees we
interviewed were unsure what medical expenses qualified for payment
using their HSAs, and that few researched the cost of services before
obtaining care.
Background:
Most Americans--about 202 million in 2006--receive health coverage
through private health plans. Over the past several years, insurers
have expanded their portfolio to include insurance plans with high
deductibles, lower premiums, and, generally, an associated savings
account to pay for services up to the deductible. These consumer-
directed health plans are designed to reduce health care spending and
encourage more consumer control. To help achieve these goals, insurers
typically offer online tools to enrollees designed to help them
evaluate the cost and quality of health care services. Experts suggest
that reliable information about the cost of particular health care
services and the quality of specific health care providers would help
enrollees become more actively engaged in making health care purchasing
decisions.
Beginning in 2004, insurers began to market HSA-eligible consumer-
directed health plans. HSA-eligible health plans are required to meet
certain statutory criteria, including minimum deductible amounts, which
are higher than health plan deductibles on average, and maximum limits
on enrollee out-of-pocket spending.[Footnote 11],[Footnote 12] HSA-
eligible plans are sold either to an individual or through group plans,
such as those offered by employers.
HSAs are tax-advantaged savings accounts established to pay for
qualified medical expenses.[Footnote 13] Individuals are eligible to
open an HSA and contribute funds if they are enrolled in an HSA-
eligible plan and have no other health coverage, with limited
exceptions.[Footnote 14] Both employers and individuals may--but are
not required to--contribute to HSAs, up to an annual limit.[Footnote
15] Individuals may claim a deduction on their federal income taxes for
their HSA contributions not exceeding the limit. HSA withdrawals for
qualified medical expenses are not federally taxed; withdrawals for
nonqualified expenses are subject to tax and, when withdrawn before age
65, an additional tax penalty. HSA account holders may access their
account funds by check, by debit card, or by allowing providers to
directly debit their account funds. Account administrators, such as
financial institutions, report to IRS the contributions and withdrawals
made to and from the accounts they manage, and individual account
holders report to IRS the amount of withdrawals they used for qualified
medical expenses or other expenses. Unused HSA balances may accumulate
from year to year without limit and earn interest. HSAs are owned by
the account holder and individuals may keep their accounts if they
switch jobs or are no longer enrolled in an HSA-eligible health plan.
Participation in HSA-Eligible Plans and HSAs Increased Significantly,
and Many HSA-Eligible Enrollees Did Not Open an HSA:
Industry estimates indicate significant increases in the number of
individuals covered by HSA-eligible health plans. For example, a series
of insurance carrier surveys conducted by AHIP found that the number of
lives covered by HSA-eligible plans increased significantly from about
438,000 in September 2004 to an estimated 6.1 million in January 2008.
[Footnote 16] Despite the growth, HSA-eligible plan coverage
represented only about 2 percent of individuals with private health
coverage in 2006.[Footnote 17]
Participation in HSAs also increased significantly. IRS data show that
the number of tax filers between the ages of 19 and 64 reporting HSA
activity nearly tripled from about 120,000 in 2004 to about 355,000 in
2005. In addition, although industry estimates varied, all indicated
continued growth in HSA participation in 2006 and 2007. For example,
one industry publication estimated that the number of HSAs managed by
major financial institutions more than doubled between 2006 and 2007.
[Footnote 18]
Despite the growth in HSA participation, many HSA-eligible plan
enrollees did not open an HSA. Nationally representative surveys of HSA-
eligible plan enrollees conducted in 2005 through 2007 found that 42
percent to 49 percent reported that they had not opened an HSA, and 20
percent to 24 percent did not plan to open one.[Footnote 19] Reasons
survey respondents cited for not planning to open an HSA included that
they could not afford them or they did not believe they needed them. On
the basis of an analysis of publicly available survey data and data
obtained from IRS, we also reported that roughly 45 percent of HSA-
eligible plan enrollees in 2004 did not report contributions to an
HSA.[Footnote 20] Similarly, industry representatives we spoke with
told us that many HSA-eligible plan enrollees did not have an HSA. The
representatives also said that they expect that there would always be
some share of eligible consumers who would choose not to open an HSA.
HSA Account Holders Reported Higher Incomes than Other Tax Filers:
Tax filers who reported HSA activity and enrollees in certain HSA-
eligible plans had higher incomes on average than other tax filers.
Among tax filers between the ages of 19 and 64, the average adjusted
gross income (AGI) for those reporting HSA activity in 2005 was about
$139,000, compared with about $57,000 for other filers.[Footnote 21]
About 59 percent of HSA filers had AGIs of $60,000 or more, compared
with 26 percent of other tax filers.[Footnote 22] Moreover, income
differences between HSA and other filers existed across all age groups.
(See fig. 1.) Income differences between HSA and other filers also
existed within different tax filing statuses, such as single or joint
tax filers. In 2006 we reported similar findings based on different
data sources covering different time periods. For example, we reported
that about 51 percent of HSA filers in 2004 had AGIs of $75,000 or
more, compared with 18 percent of all tax filers under age 65.[Footnote
23] In addition, we reported that among active federal employees
enrolled in the Federal Employees Health Benefits Program in 2005, 43
percent of HSA-eligible plan enrollees earned federal incomes of
$75,000 or more, compared with 23 percent for all enrollees.[Footnote
24]
Figure 1: Comparison of HSA and Other Tax Filers' Average Adjusted
Gross Income by Age, 2005:
[See PDF for image]
This figure is a vertical bar graph depicting the following data:
Age Category: 19 to 34;
HSA filers: $67,064;
Other Filers: $29,454.
Age Category: 35 to 44;
HSA filers: $143,681;
Other Filers: $63,943.
Age Category: 45 to 54;
HSA filers: $153,404;
Other Filers: $77,646.
Age Category: 55 to 64;
HSA filers: $189,345;
Other Filers: $81,495.
Source: GAO analysis of IRS data.
Notes: Analysis was limited to tax filers between the ages of 19 and
64. HSA filers included those reporting any contributions to or
withdrawals from an HSA. Contributions include those made by individual
tax filers or by employers or other individuals on their behalf, but do
not include any funds that were transferred to an HSA from a medical
savings account. Withdrawals did not include those made to avoid a tax
penalty by removing contributions that were in excess of the allowable
limits, or those made to transfer funds from one HSA to another. For
returns of married couples filing jointly, returns were categorized
based on the age of the primary tax filer, and the AGI included the
combined AGIs of both filers.
[End of figure]
HSA Contributions Exceeded Withdrawals and Most Withdrawals Were
Claimed for Qualified Medical Expenses:
The total value of account holder and employer HSA contributions in
2005 was about twice that of account holder withdrawals--about $754
million compared to $366 million. Among all filers reporting HSA
activity, the average HSA contribution was about $2,100, the average
HSA withdrawal was about $1,000, and average contributions and
withdrawals generally increased with both income and age. Employer
survey data provided varying estimates of the extent to which employers
contributed to their employees' HSAs. For example, a series of surveys
reported that more than a third of large employers offering HSA-
eligible plans did not contribute to their employees' HSAs in 2005,
2006, or 2007.[Footnote 25] Another survey reported that 47 percent of
small and large employers offering HSA-eligible plan coverage for
families did not contribute to their employees' HSAs in 2007.[Footnote
26]
The extent to which account holders withdrew HSA funds varied, but of
the funds withdrawn, most were claimed for qualified medical expenses.
Among filers who reported HSA contributions in 2005, about 41 percent
did not withdraw any HSA funds that year, while about 22 percent
withdrew as much or more than their reported contributions.[Footnote
27] This is consistent with statements from industry experts that
characterized HSA account holders as either savers or spenders, where
savers primarily used HSAs as a tax-advantaged savings
vehicle.[Footnote 28] Of the HSA funds that were withdrawn in 2005,
about 93 percent were claimed for qualified medical expenses. The
remaining 7 percent of withdrawals were for nonqualified expenses,
which are subject to tax and, if withdrawn before age 65, an additional
tax penalty.
We reported in August 2006 that some HSA-eligible plan enrollees we
interviewed were unsure what medical expenses qualified for payment
using their HSAs, and few researched the cost of services before
obtaining care, although many researched the cost of prescription
drugs.[Footnote 29] In addition, we reported in April 2006 that
consumer-directed health plan experts and employers told us the tools
provided by insurance carriers to assist consumers in assessing the
price and quality of health care providers and services did not provide
sufficient information to allow enrollees to fully assess the cost and
quality trade-offs of health care purchasing decisions.[Footnote 30]
They cited several reasons for this, including potential legal barriers
to greater price transparency and a lack of consensus on what would
make ideal quality measures.
Mr. Chairman, this concludes my prepared remarks. I would be happy to
answer any questions that you or other Members of the Subcommittee may
have.
For future contacts regarding this statement, please contact John E.
Dicken at (202) 512-7114 or at [email protected]. Contact points for our
Offices of Congressional Relations and Public Affairs may be found on
the last page of this statement. Randy DiRosa, Assistant Director;
Gerardine Brennan; Stephen Ulrich; and Timothy Walker made key
contributions to this statement.
[End of section]
Related GAO Products:
Health Savings Accounts: Participation Increased and Was More Common
among Individuals with Higher Incomes. [hyperlink,
http://www.gao.gov/cgi-bin/getrpt?GAO-08-474R]. Washington, D.C.: April
1, 2008.
Health Savings Accounts: Early Enrollee Experiences with Accounts and
Eligible Health Plans. [hyperlink, http://www.gao.gov/cgi-
bin/getrpt?GAO-06-1133T]. Washington, D.C.: September 26, 2006.
Consumer-Directed Health Plans: Early Enrollee Experiences with Health
Savings Accounts and Eligible Health Plans. [hyperlink,
http://www.gao.gov/cgi-bin/getrpt?GAO-06-798]. Washington, D.C.: August
9, 2006.
Consumer-Directed Health Plans: Small but Growing Enrollment Fueled by
Rising Cost of Health Care Coverage. [hyperlink, http://www.gao.gov/cgi-
bin/getrpt?GAO-06-514]. Washington, D.C.: April 28, 2006.
Federal Employees Health Benefits Program: First-Year Experience with
High-Deductible Health Plans and Health Savings Accounts. [hyperlink,
http://www.gao.gov/cgi-bin/getrpt?GAO-06-271]. Washington, D.C.:
January 31, 2006.
Footnotes:
[1] HSA-related tax advantages were authorized by the Medicare
Prescription Drug, Improvement and Modernization Act of 2003 for
individuals covered by HSA-eligible health plans--plans that meet
minimum deductibles and maximum out-of-pocket spending limits. Pub. L.
No. 108-173, �1201, 117 Stat. 2066, 2469. Both employers and
individuals may--but are not required to--contribute to HSAs, up to an
annual limit.
[2] Consumer-directed health plans generally include three basic
components--a health plan with a high deductible; an associated tax-
advantaged account to pay for medical expenses under the deductible;
and decision-support tools to help enrollees evaluate health care
treatment options and costs.
[3] HSA contributions up to annual limits are exempt from income tax,
and withdrawals for qualified medical expenses are not federally taxed.
Contributions exceeding the limit are subject to federal tax.
Withdrawals for nonqualified expenses are also subject to federal tax,
and--if withdrawn before age 65--an additional tax penalty.
[4] [hyperlink, http://www.gao.gov/cgi-bin/getrpt?GAO-08-474R]
(Washington, D.C.: Apr. 1, 2008).
[5] AHIP is a trade association representing health insurers.
[6] We defined HSA activity for a given year as any reported
contributions to or withdrawals from an HSA in that year.
[7] We also interviewed officials from the organizations that prepared
the estimates--Atlantic Information Services, Financial Research
Corporation, and Information Strategies Incorporated--however, we did
not verify the reliability of the estimates.
[8] Blue Cross Blue Shield Association, CDHP Member Experience Surveys,
2005, 2006, and 2007.
[9] Kaiser Family Foundation and Health Research and Educational Trust,
Employer Health Benefits: Annual Survey (Menlo Park, Calif., and
Chicago, Ill.: 2005, 2006, and 2007) and Mercer, National Survey of
Employer-Sponsored Health Plans (New York, N.Y: 2005, 2006, and 2007).
[10] A list of these related GAO products is included at the end of
this statement.
[11] An out-of-pocket spending limit is the most an enrollee is
required to pay toward the cost of covered services. The out-of-pocket
spending limit includes deductibles and other payments, but not
premiums.
[12] These amounts are annually adjusted for cost-of-living increases.
In 2008, the minimum deductible amount is $1,100 for single coverage
and $2,200 for family coverage, and the maximum limit on enrollee out-
of-pocket spending is $5,600 for single coverage and $11,200 for family
coverage.
[13] Qualified medical expenses are generally identified under the
Internal Revenue Code (26 U.S.C. � 213(d)).
[14] Limited coverage (including specific injury or accident,
disability, dental care, or vision care) in addition to the HSA-
eligible plan is permissible.
[15] The annual contribution limit is adjusted annually for inflation.
In 2008, contributions are allowed up to $2,900 for single coverage or
$5,800 dollars for family coverage, regardless of the amount of the
deductible. In 2007, contributions were allowed up to $2,850 for single
coverage or $5,650 for family coverage. Prior to 2007, contributions
were limited to the lesser of the deductible amount for the HSA-
eligible plan or the limits specified for each year.
[16] America's Health Insurance Plans, January 2008 Census Shows 6.1
Million People Covered by HSA/High-Deductible Health Plans (Washington,
D.C.: April 2008). The estimates included plans from the individual and
group markets.
[17] GAO analysis of America's Health Insurance Plans' 2006 and 2007
estimates of lives covered by HSA-eligible health plans, and the U.S.
Census Bureau's 2006 Current Population Survey estimate of lives
covered by private health insurance.
[18] Atlantic Information Services, Inc., "Number of HSAs Doubles Over
Past Year; Firms Now Hold Nearly $2 Billion, ICDC Finds," Inside
Consumer-Directed Health Care (Mar. 9, 2007).
[19] Blue Cross Blue Shield Association, CDHP Member Experience
Surveys, 2005 through 2007.
[20] See [hyperlink, http://www.gao.gov/cgi-bin/getrpt?GAO-06-798].
[21] The median income of HSA filers in 2005 was about $72,000 compared
with about $32,000 for other filers.
[22] Other tax filers include both insured and uninsured individuals.
The uninsured tend to have lower incomes than those with health
insurance coverage. For returns of married couples filing jointly, the
AGI included the combined AGIs of both filers.
[23] See [hyperlink, http://www.gao.gov/cgi-bin/getrpt?GAO-06-798].
[24] See [hyperlink, http://www.gao.gov/cgi-bin/getrpt?GAO-06-271].
[25] Mercer, National Survey of Employer-Sponsored Health Plans, 2005,
2006, and 2007.
[26] Kaiser Family Foundation and Health Research and Educational
Trust, Employer Health Benefits: 2007 Annual Survey.
[27] HSA withdrawals may exceed contributions in a given year if
balances are carried over from prior years.
[28] [hyperlink, http://www.gao.gov/cgi-bin/getrpt?GAO-06-514].
[29] See GAO-06-798. Information on HSA-eligible plan enrollee
experiences was gathered from focus groups we conducted of employees
from three large employers that offered HSA-eligible health plans.
These focus groups also revealed that participants generally reported
positive experiences, but most would not recommend the plans to
consumers who use maintenance medications, have a chronic condition,
have children, or may not have the funds to meet the high deductible.
[30] See [hyperlink, http://www.gao.gov/cgi-bin/getrpt?GAO-06-514].
[End of section]
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Washington, D.C. 20548:
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