Medical Savings Accounts:

Results From Surveys of Insurers

HEHS-99-34, Dec 31, 1998

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Pursuant to a legislative requirement, GAO addressed the effects of medical savings accounts (MSA) on: (1) selection, including adverse selection; (2) health costs, including any new impact on premiums of individuals with comprehensive coverage; (3) use of preventive care; (4) consumer choice; (5) the scope of coverage on high-deductible plans purchased in conjunction with such accounts; and (6) other relevant items.

GAO noted that: (1) GAO's original evaluation design called for conducting surveys of MSA enrollees and employers to obtain a consumer perspective on MSAs, and surveys of insurers and financial institutions to obtain the perspective of suppliers; (2) GAO competitively awarded four contracts to companies with experience in health economics, health insurance, and actuarial science, and selected Westat and its partners to design an enrollee survey and to complete a study of insurers' response to MSAs; (3) however, the relatively low enrollment in MSAs made it impossible to conduct useful surveys of enrollees, employers, or financial institutions at a reasonable cost; (4) consequently, GAO did not initiate such surveys; and (5) the information obtained for this study comes only from insurers, limiting the extent to which the evaluation can address the issues in the mandate.