This message was self-deleted by its author

[The Velveteen Ocelot]

19. The point is that it's your money either way. If you can't afford to deposit anything

into the HSA you are still stuck with the whole amount of the deductible. Your example is a family that "goes two or three years with limited medical expenses (and) can accumulate thousands of dollars into the HSA and get to the point where they can benefit from the lower premiums without having to pay into the HSA." This is true, but it presumes that this family can afford to make contributions to the HSA every year. This is most likely when the policy is supplied by an employer, as mine was - the premium for my group policy was quite low, so I could afford to contribute the maximum amount; when I retired I had a pretty good amount saved up. What I'm trying to explain is that HSA policies are fine for situations you describe, but not for lower-income people. Even if they have an employer-provided HSA policy (I think they all are now) with low premiums, they can't add to the HSA and so will be stuck with the huge deductibles and co-pays and un-covered expenses.

What the GOP is proposing now is using these HSAs along with private, individual policies. Those policies are not likely to have the low premiums of an employer-provided policy, and the savings accounts will be of no value to low-income people who can barely afford the premiums.