New Addition to Shareholder Lexicon:
The "Universal HSA"
John Goodman of NCPA has come out with a new idea: the "universal health savings account (HSA)." The concept is to combine the best features of the flexible spending account (FSA), health savings account (HSA), and health reimbursement arrangement (HRA). Each has upsides and downsides:
- HSAs are portable and can accumulate assets over time. However, they must be paired with a high-deductible health plan, which might scare some people off
- HRAs can be paired with any type of plan and can accumulate assets over time, but the money is not portable when an employee leaves a job
- FSAs can be paired with any type of plan. However, they are not portable and cannot accumulate assets beyond one year
The "universal HSA" would be portable, be able to accumulate assets (as current HSAs can), but could be paired with any type of health insurance plan (not just a high-deductible one).
There's a tension between those who want to use HSAs as the carrot to get people to adopt the stick of the high deductibe on the one hand, and those who want to allow almost anyone to have an HSA (besides Goodman, the "large HSA" idea at Cato comes to mind). Honest disagreement, but interesting nonetheless.

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