How to Expand Health Care Choice and Access

Throughout the 2020 campaign, voters have looked for candidates who will strengthen financial security for the American people and deliver health care choice and access to families.

While there are many proposals that could help achieve these goals, one simple way to do so is by expanding Health Savings Accounts (HSAs) so that Americans can pay for their health care tax-free during the duration of the pandemic. 

Newly released polling data conducted by McLaughlin and Associates found that voters support this policy by a margin of four to one with 67 percent of respondents supporting the policy and just 15 percent opposing it. Importantly, support for HSA expansion is bipartisan – the policy is supported by over 65 percent of independents, 70 percent of Democrats and nearly 65 percent of Republicans.

This proposal can be enacted by passing S.3546/H.R. 6338, the Pandemic Health care Access Act, a one-page bill introduced by Senator Ted Cruz (R-Texas) and Congressman Ted Budd (R-N.C.).

Today, 30 million American families and individuals use HSAs to pay for common health care expenses, including doctor’s visits, prescription drugs, and hospital care. However, hundreds of millions of Americans do not have access to an HSA because of the government requirement that says Americans only qualify for an HSA if they have a high deductible health plan (HDHP).

The Pandemic Health care Access Act suspends this requirement for as long as the coronavirus emergency declaration is in effect.

While the Cruz-Budd proposal is simple, it will have significant benefits for the American people.

The legislation will increase access to health care by making HSAs available to self-employed Americans including the millions of gig-economy workers, every American that receives health care through their employer, Americans on Medicare and Medicaid, and those that receive care through the VA, Indian health plans, and ObamaCare.

It will help individuals pay for their deductible or any increased health care costs, for direct primary care, and for telemedicine.

In addition, because HSA funds are owned and managed by the individual, this reform will encourage efficient health care spending.  Research has shown that families and individuals with an HSA tend to spend less on health care and use fewer medical services without forgoing necessary primary and preventative care.

Not only will HSA expansion help Americans pay for their health care, it will also cut taxes for families by allowing them to save, invest, and spend health care dollars tax-free.

Any money contributed to any HSA is tax-deductible, any money invested in an HSA can grow tax-free, and any money spent on qualified health care expenses from an HSA is tax-free.

These tax benefits mean HSAs help Americans saving for retirement and long-term health care costs in the same way that 401(k)s are used by roughly 100 million Americans to build a nest egg.

While policymakers will rightly scrutinize the revenue or spending cost of any policy proposal, HSA expansion should be weighed against the cost of health care expansion proposals pushed by the left, all of which would result in billons or trillions of dollars in new spending.

For instance, Democrat presidential nominee Joe Biden’s proposal to lower the Medicare eligibility age to 60 and impose a “public option” would increase spending by anywhere from $1.8 trillion to $2.2 trillion.

The “Medicare for All” plan pushed by socialists like Alexandria Ocasio-Cortez (D-N.Y.) and Bernie Sanders (I-Vt.) would cost $32 trillion and lead to trillions in middle-class tax increases.

It is also important to note that HSA expansion is a tax cut – not a spending increase. In other words, HSA reform means the government is taking less money from people.

In addition, HSA expansion can be scaled up or down. A proposal could permanently expand HSAs for everyone, or simply expand it to those on Medicare or the self-employed.

As we near the end of the 2020 election cycle, American families are looking for solutions that will improve their financial security and strengthen health care choice and access.

Expanding HSAs so that Americans can pay for their health care tax free through the pandemic is one way that policymakers can achieve these goals. Not only will this cut taxes and improve health care for Americans, but there is strong bipartisan support for this policy, as new polling data confirms.

Grover Norquist is President of Americans for Tax Reform