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Originally Posted by middle-aged mom
A statistically insignificant percentage of the U.S. population has participated in the 2003 HSA federal tax shelter. As I understand it, about 4.5 million people maintain HSAs. Of this, only about 1 million do so independent of their employers.
HSAs survived the ACA with some changes. ACA increased the annual cap of money one may temporarily shelter from federal taxes for purposes of future medical expenses. ACA lowered the max on FSA, making contributions to an HSA more attractive to those who can afford them. ACA also allowed HSA withdrawals for preventative health care that was previously not possible.
In contrast, ACA increased the previous penalty for non medical withdrawals and as I understand it, did so because such accounts were being used to shelter income more so than to save towards future medical expenses.
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What the ACA does to HSAs is to prevent the pairing of a cheaper, more catastrophic plan which makes more financial sense to those who can plan. When you combine a more expensive plan the increase in premiums makes funding the HSA more difficult and MORE out of reach for the average person DESPITE the large deductibles associated with the ACA compatible plans.
Whether you have a loaded plan with max out of pocket expense of 12K or bare bones plan with out of pocket max of 12K, why pay more for the loaded plan? You want enough saved in your HSA to cover your max OOP.
The ACA merely subsidizes insurance companies to give forth higher priced yet still garbage plans to the general public. Their deductibles are higher than the average per capita health expense for a reason. People will be paying higher premiums to pay for care until they (and mostly likely won't occur) reach deductibles. You've got the world's most expensive Physical Examination thanks to the govt.