Where small business managers see Health Savings Accounts as an avenue to reduce healthcare costs, some experts worry that employees will be hit with higher plan costs.

Many experts believe the sharply higher health insurance deductibles associated with utilizing an HSA will hit workers in the next two years as employers embrace these newly created tax-free plans.

Designed to make users more aware of the true costs of healthcare and to provide a new tax-advantage avenue for retirement, HSAs are expected to be a significant factor in the near future.

One survey thinks HSAs will have a broad and overwhelming effect.

Nearly three-quarters (73%) of employers asked by Mercer Human Resource Consulting said they were likely to offer the new accounts.

"We're looking at a major market change," says Linda Havlin, Mercer's Midwest health care practice leader, noting that a 73% interest in adopting a new program within two years "is unprecedented."

The interest reflects employers' frustration with double-digit increases in health care costs and a dearth of new ideas for dealing with those costs.

HSAs cam help employers shift some of the cost of health care to workers and may also result in lower insurance premiums. HSAs were approved by Congress late last year as part of the Medicare reform legislation and enable policyholders set aside money tax free to cover health care costs.

Unspent money earns interest and can be rolled over, but the accounts must be coupled high deductible insurance policies of at least $1,000 for individuals and $2,000 for families.

Widespread adoption of the plans could drive up the average annual deductible paid by workers, which is now about $300 for single employees and $600 for families, according to data from Mercer and the Kaiser Family Foundation.

Mercer's survey of 991 employers found that 61% would set the individual annual deductible for an HSA plan at $1,000. But 17% chose $1,500, 11% said $2,000 and 10% were above $2,000.

Don't expect employers to pay that deductible: The Mercer study also found that 39% would not put any money into the savings accounts for workers, while 24% would put in $500 a year, leaving it up to the workers to fund the rest.

Supporters say the accounts will help increase the number of insured Americans and help Americans save for retirement health costs. Critics say the accounts will mainly benefit the rich and could ultimately leave workers paying the majority of their own health costs, much as pensions were replaced by 401(k) savings accounts at many workplaces.

In a March survey, the National Business Group on Health found that 25% of employers surveyed already had a high-deductible health plan as a benefit offering.

"There will be a big jump in interest," says Helen Darling, who heads the employer coalition.

Not everyone believes HSAs will blossom as widely as the survey seems to indicate. Some experts believe employee resistance and a natural inclination by many companies not to foster radical change on employees will slow this process.

"With any new idea, there's a lot of publicity, and employers say they're interested," says Bill Sharon, senior vice president Aon Consulting. "But after they have time to reflect on it and see whether it fits into their own organization, that number comes way down."