This comment examines the drawbacks and potential efficiencies associated with Health Savings Accounts (HSAs), and discusses whether HSAs will deliver the purported benefits of reducing aggregate healthcare costs by encouraging value-conscious decisions and increasing cost transparency, thereby reducing the number of Americans without healthcare coverage. The author then discusses several initiatives by state, federal, and private organizations that could ensure wider availability of the tax benefits associated with HSAs, which would broaden the appeal of such accounts for lower income Americans. After analyzing the background of HSAs, recent developments, and potential improvements, the author describes the current political environment surrounding healthcare coverage and the uncertain future of tax-favored accounts.

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