OPINION ARTICLE: Expanding Health Savings Accounts

Expanding Health Savings Accounts: A Path to Greater Patient Choice and Lower Healthcare Costs

Written By: Dr. Chaminie Wheeler, DO Pediatrics, Direct Primary Care

In recent years, the U.S. Congress has introduced multiple bills aimed at expanding and modernizing Health Savings Accounts (HSAs). These legislative efforts are rooted in the recognition that HSAs empower individuals to take control of their healthcare spending, foster a competitive free market, and ultimately reduce the cost of healthcare. By broadening access to HSAs and increasing their flexibility, these initiatives provide Americans with greater autonomy in managing their healthcare dollars and making informed choices about their medical needs.

ENHANCING PATIENT CHOICE AND FINANCIAL FLEXIBILITY

One of the most significant advantages of HSAs is their ability to increase patient choice in healthcare. Currently, many Americans are constrained by employer-based insurance plans with limited options for providers and services. HSAs, particularly when decoupled from high-deductible health plans (HDHPs), enable individuals to allocate funds for healthcare expenses based on their specific needs. The Personalized Care Act (H.R. 5810) introduced in January 2025 seeks to achieve this by allowing individuals to contribute to HSAs regardless of their insurance plan type. This expansion ensures that more Americans can benefit from tax-advantaged healthcare savings and access a wider array of services, including direct primary care and healthcare-sharing ministries.

Additionally, the proposed HSA Modernization Act of 2023 (H.R. 5687) increases contribution limits, allowing individuals to save more tax-free dollars for medical expenses. By raising limits to $10,800 for individuals and $29,500 for families, patients have greater financial security in managing their healthcare expenses. This flexibility enables families to plan for both routine medical care and unexpected health emergencies without being overly dependent on third-party payers or government programs.

STRENGTHENING THE INDEPENDENT PHYSICIAN MOVEMENT

Expanding HSAs provides a critical advantage to independent physicians by giving patients greater financial autonomy, making direct primary care (DPC) and independent practices more accessible. When patients control their healthcare dollars, they are more likely to choose physicians who offer transparent pricing, personalized care, and innovative treatment models outside of hospital networks. Moreover, by allowing HSAs to cover direct primary care fees and specialty services, these reforms could help independent physicians to thrive without relying on insurance companies.

VERTICAL INTEGRATION OF HEALTHCARE HAS MERITS, BUT

HASN’T YET YIELDED THE PROMISE OF REDUCED COSTS AND

INCREASED PATIENT CHOICE.

Expanding HSAs empowers patients to spend directly on care rather than navigating insurer-imposed restrictions. The Healthcare Freedom Act (H.R. 5842) proposes “Health Freedom Accounts,” which would allow tax-free withdrawals for a variety of medical expenses, including insurance premiums and direct primary care memberships. This could help patients opt out of more restrictive insurance networks and opt in to independent providers who offer more affordable and transparent pricing. Furthermore, reducing the reliance on third-party payers encourages competitive pricing, making healthcare more affordable while fostering an environment where independent physicians and specialty care providers can thrive. By expanding HSAs to cover a broader range of healthcare services, patients will be incentivized to seek care from physicians who provide cost-effective, high-quality treatment.

CONCLUSION

The expansion of HSAs through legislative efforts such as the Personalized Care Act (H.R. 5810), HSA Modernization Act (H.R. 5687), and Healthcare Freedom Act (H.R. 5842) represents a crucial step toward increasing patient autonomy, fostering a competitive healthcare market, and reducing overall healthcare costs. Additionally, these reforms provide a pathway to strengthening independent medical practices. By giving individuals the ability to manage their healthcare dollars and choose providers that best meet their needs, these initiatives pave the way for a more patient-centered and financially sustainable healthcare system.

One of the most significant advantages of HSAs is their ability to increase patient choice in healthcare. Currently, many Americans are constrained by employer-based insurance plans with limited options for providers and services.

Published in Lehigh County Health & Medicine SPRING 2025