HSA Enrollment Reaches 11.4 Million

Larry Grudzien
June 20, 2011  

A release from America’s Health Insurance Plans: AHIP Urges Policymakers to Prevent Disruption for HSA Policyholders

Washington, DC – More than 11.4 million Americans are covered by Health Savings Account (HSA)-eligible insurance plans, a more than 14 percent increase since last year, according to a new census released today by America’s Health Insurance Plans (AHIP) finds.  Health Savings Accounts were authorized starting in January 2004.  Since then, AHIP has conducted an annual census of health plans participating in the HSA health plan market. This year’s census shows that enrollment in HSA plans has nearly doubled over the last three years, from 6.1 million enrollees in January 2008 to 11.4 million in January 2011.
“HSA plans continue to be a vital source of affordable coverage for millions of families and employers across the country,” said Karen Ignagni, President and CEO of AHIP.
Key findings from the census include:

  • As of January 2011, approximately 11.4 million people were covered by HSA plans, an increase of more than 14 percent since last year.
  • Between January 2010 and January 2011, the fastest growing market for HSA plans was for large-group coverage, which rose by 26 percent, followed by individual market coverage, which grew by 15 percent.
  • In the individual market, 2.4 million covered lives are enrolled in HSA plans, while approximately 2.8 million lives were enrolled in HSA coverage in the small-group market and over 6.3 million lives were covered in the large-group market.
  • States with the highest levels of HSA enrollment were California (1,073,319 enrollees), Texas (844,832 enrollees), Ohio (728,868 enrollees), Illinois (690,509 enrollees), Florida (656,243 enrollees) and Minnesota (507,307 enrollees).

AHIP is reaching out to policymakers on both sides of the aisle about ways to mitigate the potential unintended consequences of provisions in the new health care reform law that could disrupt or limit the availability of coverage through HSA plans, including: 

  • Restrictions on Over-the-Counter Medications: Starting this year, HSA funds can no longer be used to purchase over-the-counter (OTC) medications without a prescription.  This requirement reduces consumers’ access to common OTC drugs, such as allergy medications, and instead provides an incentive to use higher-cost prescription drug alternatives. 
  • Medical Loss Ratio: The medical loss ratio (MLR) regulation is particularly problematic for HSA-eligible plans.  By Congressional design, these plans are intended to provide consumers with a high-deductible, low-premium coverage option along with the ability so save for health care expenses through an HSA.  While these plans typically have lower benefit costs, they are not necessarily less costly to administer on a per-enrollee basis, and, as a result, naturally have lower loss ratios.  Policymakers should recognize the unique nature of HSA plans to preserve consumers’ access to this important coverage option. 
  • Minimum Actuarial Value Requirement: Effective in 2014, insurance coverage sold in the individual and small-group markets must meet certain minimum actuarial values for each level of coverage provided: bronze, silver, gold, and platinum.  The lowest level, bronze, must have a minimum 60 percent actuarial value, which is the dollar value of the average expected benefits paid out by the plan.  The ACA directs the HHS Secretary to establish the process for determining actuarial values and states that the Secretary “may” include the amount of the annual employer HSA contributions toward the actuarial value calculation.  Including employer HSA contributions in the actuarial value calculation significantly increases the likelihood that HSA plans will meet the minimum requirement and will help ensure consumers continue to have access to the high-quality, affordable coverage they rely on today. 

For the full report and slides, please visit the links below:
Full Report: http://www.ahipresearch.org/pdfs/HSA2011.pdf
Slides: http://www.ahipresearch.org/pdfs/HSA2011-slides.pdf

Larry Grudzien  
(708) 717-9638