They are for rich people who want to try and not use benefits to get a tax break. It's a Bush era tax scheme and we all know how those worked out.
From the wrap-up:
The future of HSAs
As for what will come of HSAs in the ever-shifting landscape of health reform, there's likewise disagreement. None of the bills currently under consideration in Congress so much as mention HSAs. But Daniel Perrin of the HSA Coalition, a nonprofit lobbying group, worries that savings accounts could still be crowded out by the effects of reform.
For example, says Perrin, most of the proposed reform legislation would require plans to offer a minimum level of benefits, which would make it harder for insurers to keep premiums low by limiting coverage. Those low-premium, high-deductible plans are the ones HSAs are intended to support.
"I'm going to get the same price for a plan with a $500 deductible or a $4,000 deductible -- why would I do that?" Perrin asks. This, he insists, is what transpired in Massachusetts when it implemented its health-exchange-based system in 2006.
Yet even if the benefit requirements pass unscathed -- Sen. Max Baucus, for example, has countered with a plan that would offer four benefit levels ranging from "Bronze" to "Platinum" -- Park notes that the Congressional Research Service estimates that most high-deductible plans could remain in place by increasing the benefits they provide.
And according to the Massachusetts Department of Revenue, which tracks HSAs through tax filings, the accounts have survived that state's reform -- which includes minimum benefit levels -- just fine. The number of HSA-using tax filers in Massachusetts rose from 2,195 in 2005, the year before the state enacted its new health insurance system, to 7,434 in the still-incomplete 2008 tax year, with more expected to file in the coming months.
Entrepreneur Andrew Field hopes that HSAs not only survive but can be improved. While he's pleased that HSAs have his employees "thinking like consumers," he admits that the medical system is not especially forthcoming about the prices on its menus: Finding information to comparison-shop for medical services "has not been great," he says. One of his top requests for health reform: "I would look at requiring pricing to be disclosed. That's a pretty-nonintrusive regulation."