The surveyconcluded that "few US adults who were enrolled in HDHPs were usingHSAs to save for health care expenses, despite the cost-relatedbarriers to access."

Employers, health care systems andhealth plans should consider "targeted interventions" to encouragegreater use of health savings accounts that could help make healthcare services more affordable to individuals enrolled inhigh-deductible health plans, a new study asserted.

The study, "Use of Health Savings Accounts Among US AdultsEnrolled in High-Deductible Health Plans," was based on asurvey of 1,637 individuals during several months in 2016.

The survey concluded that "few US adults who were enrolled inHDHPs were using HSAs to save for health care expenses, despite thecost-related barriers to access and financial burdens experiencedby the growing number of HDHP enrollees."

Related: Report: HSAs not meeting long-termneeds

Enrollees in HDHPs pay higher deductibles, but lower premiums,and can use HSAs to save for health expenses before taxes. U.S.regulators say an HDHP enrollee who doesn't need manyhealth care services can benefit from a lower monthly premium.

About 1 in 3 respondents did not have a health savings account,according to the study, and more than half of the individuals withan HSA had not contributed money into it within the last 12 months.The study found that "less education and health insurance literacywere associated with not having made contributions."

"These findings suggest that many US adults enrolled in an HDHPlack an HSA, and few with an HSA saved for health care in the lastyear," the authors wrote.

The authors noted significant recent legislative activity targeting HSAs, which werefirst enacted in 2003. At least 23 bills "have been introduced toexpand eligibility for HSAs to more than just HDHP enrollees,increase HSA contribution limits, or broaden the list of servicesthat can be paid for with funds from an HSA."

But the authors expressed some concern that legislative activitywould provide any benefits "without concomitant efforts to supporteligible individuals to take advantage of their eligibility andfacilitate their acquisition of an HSA."

New concerns are being raised about the costs of HDHPs. A newsurvey from The Physicians Advocacy Institutesaid the average deductible for covered employees had risen 212%between 2008 and 2018, and premiums for employer-sponsoredinsurance had risen by 55% during that period.

"High-deductible health plans were supposed to make us betterhealth care consumers, but they have failed," Donald J. PalmisanoJr., executive director and chief executive officer of the MedicalAssociation of Georgia, said recently. "They force people attractedby low premiums to choose between health care and housing, or food.They're an idea that turned out to be bad for both patients anddoctors."

Mike Scarcella is a senior editor inWashington at BenefitsPRO sister site, Law.com. Contact him at[email protected]and onTwitter @MikeScarcella. 

Read more: 

• It's time to emancipate the HSA
• High-deductible health plans are popular but costlyto patients
• Employees don't know HSAs might also be used forretirement saving