As is usually the case with HSAs, what at first blush is seen as negative data, sometimes isn’t as bad as reported.

A Government Accountability Office report chronicling a possible negative aspect of HSAs pulls back its hypothesis inside the report.

The new report about the Federal Employees Health Benefits Program indicates that a higher proportion of enrollees were younger and had income over $75,000. However, on second reading, the report also says that federal employees are also opting for another new, non-HSA program as well.

The study, first reported in CQ Healthbeat, also reported quotes from opponents of the program who claim it disenfranchises poorer, sicker individuals.  Deeper inside the report, however, are some caveats.

AFL-CIO Threat To Banks

At the same time, it is reported that the AFL-CIO is putting the leaders of a dozen banks on notice that it will hammer them if they get behind HSAs.

The labor federation hopes for a repeat of 2005, when its pressure kept some financial firms from stumping for Social Security private accounts. The targeted banks have founded a lobbying coalition to push for the health accounts. But unions contend that replacing employer-provided insurance with HSAs will undermine the financial security of workers—who are also bank customers.

According to the GAO report, it examined data for the first year in which HSAs became available in FEHBP, the average age of members who enrolled in high-deductible plans associated with HSAs was 46, compared with 59 for all members.

In addition, the report finds that, when retirees are excluded, the average ages of FEHBP members who enrolled in high-deductible plans associated with HSAs was 44, compared with 47 for all members.

Other New Insurance Plans Attractive

However, according to the report, a new health plan unrelated to HSAs that recently became available in FEHBP also attracted a higher rate of younger members. The report states, "Thus it is not clear whether younger individuals were uniquely attracted to high deductible health plans, or if younger enrollees are typical of recently introduced health plans in general." The report finds that 43% of FEHBP members who enrolled in high-deductible plans associated with HSAs had annual incomes of $75,000 or more, compared with 23% of all members.

According to the report, the results indicate that high-deductible plans associated with HSAs "uniquely attract higher-income individuals with the means to pay higher deductibles and the desire to accrue tax-free savings." The report also finds:

• Cost-sharing for preventive care for FEHBP members enrolled in high-deductible plans associated with HSAs was "the same or less than (for) traditional plan enrollees and always covered certain preventive care services before the deductible was met," although the same services "were not always covered before the deductible by their traditional plan counterparts";
  
  
• Traditional health plans were much more likely than high-deductible plans associated with HSAs to cover prescription drugs before the deductible was met; and
  
  
• Monthly premiums for high-deductible health plans associated with HSAs averaged $91 for individuals and $208 for families, compared with $99 and $243, respectively, for traditional plans.

Rep. Pete Stark (D-Calif.) said the report "verifies" that high-deductible plans associated with HSAs "are designed for healthy, wealthy people," adding, "Despite this reality, President Bush is pushing them on low-income workers—not to provide them with better health insurance, but to meet his long-term goal of dismantling employer-provided health care”.