| 摘要 | The centerpiece of President Bush’s healthcare agenda–the health savings accounts (HSAs) created as a part of the 2003 Medicare drug law–is starting to benefit individuals, families, small businesses and family farms across America by making health insurance more affordable.
But it is President Bush’s second-term plans for a national market in health insurance that will make Iowa the biggest winner of any state in terms of generating jobs and growing the Iowa economy.
Like looking to Canada for cheaper drugs, other states could look to Iowa for cheaper health insurance.
By making it possible for residents in states with high insurance costs such as New York, New Jersey and Minnesota to buy health policies in Iowa, the state will attract an enormous amount of new insurance business because it has among the lowest average health-insurance costs for individual policies.
On Oct. 12, eHealthInsurance, the largest source of health insurance for individuals and families, reported that Iowa has the lowest average health-insurance premiums for single policies among the 43 states in which it does business. The eHealthInsurance report provides a fair approximation of the relative costs of insurance among the states.
This idea of buying health insurance across state lines is extraordinarily popular. A recent Zogby poll for the Council for Affordable Health Insurance showed that 72 percent of the American people support allowing someone living in one state to purchase insurance from another state if it is state-regulated and approved. Also, 82 percent said they would be likely to buy a policy across state lines if they were paying very high rates and needed access to more affordable health-insurance policies. Minnesotans could save 25 to 30 percent on health-insurance premiums by being able to buy in Iowa. New Jersey and New York residents could cut their premiums in half.For Iowa, it would mean a big windfall in new jobs for the insurance and banking industry.
Assurant Health reports that 43 percent of its HSA applicants were previously uninsured. Similarly, eHealthInsurance reports that about 33 percent of its HSA purchasers were previously uninsured.
For individuals and small businesses with health insurance, HSA-qualifying plans allow them to dramatically lower their premiums and use the savings to build wealth through good health by depositing the savings into tax-free HSAs. For example, an Iowa ob-gyn clinic with 13 employees moved to a HSA-eligible insurance plan in 2004 and saved $40,608 (38 percent) in comparison to what a traditional PPO plan offered. A small Iowa counseling business with eight employees moved to a HSA-eligible insurance plan in 2004 and saved $14,740 (32 percent).
In both examples, the rise in premiums of traditional health plans made it difficult to continue health coverage. With HSA-eligible plans, both employers funded employee HSAs with a good portion of the premium savings. Because HSA is personal property, the savings move with the individual from job to job. HSA savings can be withdrawn tax-free for medical expenses and any remaining HSA savings enjoys a tax-free interest buildup and can be withdrawn upon retirement for any reason at ordinary tax rates.
The HSA concept is much like the government mortgage deduction that helps individuals and families build equity in a house. In this case, there is a deduction for HSA contributions so individuals have the incentive to maintain good health and build HSA savings. A person who eats well, exercises and spends wisely on preventive care can build enormous personal savings. An Iowan entering the work force at age 21 who deposits $1,000 each year into a HSA can save up to $120,000 by age 65.
In the past decade, Iowa has managed to keep its health-insurance costs reasonable relative to other states. Now there is an opportunity for Iowa leadership to take advantage of plans for a national market and become the leader in providing affordable health-insurance coverage.
Newt Gingrich is a senior fellow at AEI. Vince Haley is a project director at the Center for Health Transformation in Washington, D.C. |
