Continued Presidential support of Health Savings Accounts (HSAs), and indications by a key House Democratic health advisor bode well for the growth and development of consumer-directed healthcare—no matter who controls Congress after the fall elections.

Senior managers representing 90+% of all HSA account holders in the US met with senior officials in Washington DC this week in the second annual White House HSA Briefing, which was organized by Information Strategies, Inc.

The future of HSAs was discussed this week in a private meeting at the White House Executive Offices, by a group 75 that included every major HSA custodial institution as well as community bank and credit union leaders.  Also present were senior managers from the three major back office financial managers and major card companies. Health and Human Services Secretary Michael O. Leavitt offered strong support for HSAs. In remarks clearly aimed to demonstrate the administration’s resolve to expand HSAs, Leavitt spoke forcefully of the need to control healthcare costs while improving healthcare services to all levels of society.

After the briefing, participants adjourned to a luncheon, co-sponsored by Open Solutions, where Jon Sheiner, chief aide on health matters to Representative Charles Rangel (NY), outlined what Democrats saw as their healthcare priorities.  Rangel will be Chairman of the House Ways and Means Committee should the Democrats take control of that body.

Sheiner clearly signaled to his audience that attempts to roll back HSAs were not part of the party’s main agenda. He said the focus would be on the need for medicare reform and to protect the the nation’s 47 million uninsured.  He also singled out greater healthcare systems integration and pay-for-performance measures as targets, should the Democrats prevail.  He indicated a Democratic preference to work with Republicans on these goals.

Leavitt's strong remarks to an audience clearly well-disposed to HSAs, were greeted with spirited comments and questions.  He was clearly speaking to a receptive audience when he talked about the four keys to improved healthcare delivery—system interoperability, a focus on wellness and prevention, pay-for-performance incentives and pricing transparency.

Questions to the Secretary focused on ways to improve educational efforts to the nation’s consumers and to reduce increases in healthcare premium costs.

Brad Campbell, Deputy Assistant Secretary of Labor for Employee Benefits, spoke in the morning session at the behest of last year’s briefing participants.  He is charged with managing the implementation of ERISA mandates, and focused his address on key issues for employers and custodians surrounding HSA implementation and management.  Audience questions to Campbell centered on employer contributions and the means to provide incentives to employees to sign up for custodial accounts.

He outlined the Department’s desire to be as flexible as possible in terms of custodial account funding, but also said they now look to Congress for clarification.

With only a few extra votes in House for the new majority, and the GOP still in control of the Senate and White House, Democrats will turn to their oversight function to prod GOP members into compromise, a preferred approach for Rangel. Other areas of Democratic interest are funding the Medicare doughnut hole (at least for the lower-income), restoring payments to physicians by eliminating the Medicare Advantage PPO stabilization fund, and giving CMS some negotiating power over some Part D drugs.

The meeting came on the same day that a new HSA markup was reported by the House Ways and Means Committee and sent to the full committee for discussion.

The day’s final speaker was Roy Ramthun, former Presidential Advisor on Healthcare.  His comments were more soothing to the audience after Sheiner’s strong presentation of the Democratic Party viewpoint.

He, like all the speakers, emphasized the continued growth of HSAs and the expectations that they would continue to grow substantially during the coming year.

Ramthum said the key to continued growth was to make HSAs a bipartisan offering and to highlight the advantages of HRAs when employers can’t offer HSAs.

JoAnn Laing, President of Information Strategies, Inc. presented the company’s latest projections for HSA growth, while offering new insights into who are the main purchasers of HSAs.