Author Topic: Thoughts on what would happen to HSA's if we went to a single payer system  (Read 2865 times)


  • Bristles
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What do you all think would happen with current HSA money if we to a single payer system. I believe under the Bernie Sanders plan there are no premiums, co payments, or deductibles. While I do not think this has a big chance of passing now, I do think the chances are decent that it would pass in my lifetime. What do you all think would happen with current HSA money if this were to happen? I know there is no way of knowing this, just curious what you all think!

1. Current HSA rules where it is essentially a trad IRA at 65?
2. Would become a trad IRA instantly (And could be apart of the rollovers)
3. Something else?


  • Senior Mustachian
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Well as you alluded to in your post, there's a number of ways that a single-payer healthcare system could be disbursed.  If we could still choose our level of coverage (but just have one option who we purchased healthcare from) then I'd expect the HSA could remain largely the same.

EVen if we switched to a single-payer system that was funded entirely by taxes (similar to what's available in Canada) an HSA could still persist, as there would likely still be a secondary insurance market for things like vision/dental, individual hospital rooms and elective surgery. If that happened, however, I'd imagine that the HSA limits would go down considerably.


  • Magnum Stache
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Well given that medicare is similar to single payer, and you still pay quite a bit with that, I would expect that you can withdraw from an HSA tax free for medical but that you might not be able to contribute to it.


  • Magnum Stache
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Single payer doesn't mean everything is covered, and the Sanders plan does have premiums of 8.4% of your income, in addition to much higher income taxes and taxes on interest and dividends. HSA's could be used to pay those premiums or for optional healthcare services. Maybe you want a dental cleaning three times a year instead of twice, or there might be fees for non-emergent use of the ER, or convenience fees for urgent care... lots of possibilities.


A 6.2 percent income-based health care premium paid by employers.
A 2.2 percent income-based premium paid by households.
Taxing capital gains and dividends the same as income from work.
37 percent on income between $250,000 and $500,000.
43 percent on income between $500,000 and $2 million.
48 percent on income between $2 million and $10 million.
52 percent on income above $10 million.


Wow, a phone plan for fifteen bucks!