HSA Enrollment Keeps Growing

AHIP’s latest census of HSA-qualifying insurance coverage contains some fascinating information. Keep in mind these numbers are for HSA-qualifying coverage only. It does not include HRA plans or stand-alone high deductibles.

The finding reported in most of the news stories is that enrollment in these plans grew from 11.4 million in January 2011 to 13.5 million in January 2012, an increase on 18% in one year.

This continues the steady growth documented by AHIP’s annual surveys. The trend line is unmistakable –

The vast majority of this enrollment surge is in the large group category, which suggests that large employers are not waiting around to see what happens with the Affordable Care Act. They are moving ahead to increase consumerism with or without ObamaCare.

AHIP also provides state-by-state enrollment information, which may be surprising. The assumption has usually been that HSAs are the darling of conservative Republicans and despised by liberal Democrats, but that idea is belied by the states that have embraced or rejected these plans. The top five states in terms of market penetration are –

Vermont (19.9%)

Minnesota (14.3%)

Montana (12.1%)

Utah (11.5%)

Connecticut (10.6%)

The bottom five states are –

Hawaii (0.3%)

Alabama (1.3%)

Mississippi (1.6%)

West Virginia (1.8%)

New Mexico (2.0%)

Also fascinating are the average premiums for these plans on a state-by-state basis. AHIP’s calculation averages premiums for all markets — individual, small group, and large group. Below are the average monthly premiums for single (not family) coverage in the most and least expensive five states –

High Cost

New Hampshire   $ 467

Massachusetts      $ 453

Rhode Island        $ 432

Connecticut          $ 424

California              $ 422

Low Cost

South Dakota       $ 206

Iowa                       $ 235

Maryland              $ 241

Minnesota            $ 264

Michigan              $ 277

Interesting that there doesn’t appear to be any correlation between cost and market penetration. Minnesota is one of the low-cost states and has high enrollment, but Connecticut is one of the high-cost states and also has high enrollment