The top-ranking Democrat on the Senate side of the JointEconomic Committee says expanding the health savings account program would dolittle to help ordinary Americans cope with cuts in Affordable CareAct coverage expansion programs.

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Sen. Martin Heinrich, D-N.M., makes the case against seeing HSAexpansion as a substitute for ACA coverage expansion programs ina response to the HouseRepublicans' American Health Care Act proposal.

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The AHCA proposal would wind down the ACA Medicaid expansionprogram and replace the income-based ACA premium tax credit with anage-based premium tax credit. Drafters have tried to compensate forthat by letting people contribute more to HSAs. Lawmakers couldpropose additional HSA program expansion provisions as the proposalmakes its way through the House and the Senate.

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Related: Trump backs health tax credits that have splitRepublicans

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People who combine HSAs with high-deductible health coveragethat meets HSA program standards can avoid paying federal incometaxes on contributions to the accounts, or on the withdrawals usedto pay for eligible health care products and services.

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The 2017 HSA contribution limits are $3,400 for an individualand $6,750 for a family.

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Heinrich argues that the AHCA proposal to increase the maximumHSA contribution limit would do little good for ordinary families,because ordinary families have no way to max out their HSAs, evenunder the current limits.

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"Only 53 percent of American families save at all, and familieswho are wealthier are more likely to be able to save," Heinrichwrites. "Less than half of low- and middle-income families are ableto save."

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An individual would have to save $214 per month for a year tocover the cost of a year of treatment for Type 1 diabetes, and $508per month for a year to cover the cost of an appendectomy, Heinrichwrites.

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U.S. Treasury Department figures show that even families withannual gross income of $100,000 to $200,000 have an average of lessthan $5,000 in their HSAs, according to a chart accompanying thecommentary.

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The only taxpayers with an average HSA balance of more than$8,000 are those with more than $500,000 in annual income,according to the chart.

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HSAs "allow Republicans to claim they provide families freedomof choice, while providing another way for the wealthiest among usto pay less," Heinrich writes.

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Allison Bell

Allison Bell, ThinkAdvisor's insurance editor, previously was LifeHealthPro's health insurance editor. She has a bachelor's degree in economics from Washington University in St. Louis and a master's degree in journalism from the Medill School of Journalism at Northwestern University. She can be reached at [email protected] or on Twitter at @Think_Allison.