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Washington, D.C.—A government report on the use of health savings accounts (HSAs) in the federal health care system echoes a number of concerns raised by the National Treasury Employees Union (NTEU) about the impact these tax-exempt financial tools likely would have on health insurance premiums for the vast majority of federal workers, retirees and their families.

The report, by the Government Accountability Office (GAO), takes a look at first-year enrollment in high-deductible health plans coupled with HSAs being offered by insurers under the Federal Employees Health Benefits Program (FEHBP).

While only 7,500 out of some eight million potential enrollees have chosen this approach, GAO said the first-year data “does raise the possibility that individuals with certain demographic characteristics may be disproportionately attracted to these plans.”

And that is exactly the problem NTEU President Colleen M. Kelley called attention to as the Office of Personnel Management (OPM) began pressing private insurers to include HSAs in their FEHBP plans.

HSAs “threaten the stability of the FEHBP,” Kelley said, by drawing in enrollees who do not anticipate high health care costs for that plan year—mainly younger and wealthier people—thus leaving a smaller pool of people in traditional plans. The obvious impact of that would be to trigger even higher health care costs for the federal employees and retirees in those plans. FEHBP is the nation’s largest group health plan, covering more than eight million people.

“Every year, federal employees pay rising health care costs—and all-too-often, sharply-rising costs,” President Kelley said. “The government should be using the strength of FEHBP to help keep costs down, not pushing them up by pursuing such mechanisms as HSAs.”

In the GAO report’s conclusion, the agency said it appears that high-deductible/HSA plans “uniquely attract higher-income individuals with the means to pay higher deductibles and the desire to accrue tax-free savings.”

The average age of enrollees in such plans was 13 years younger than that of all FEHBP enrollees, GAO said, adding that 43 percent of actively-employed federal workers in the high-deductible/HSA plans earned at least $75,000, compared to the 23 percent of enrollees in all FEHBP plans who earned that much.

On another matter—also previously raised by President Kelley—GAO said that while such plans are based on the idea that enrollees will become more actively involved in their health care purchase decisions, the fact is that specific information needed to make assessments like the actual prices plans had negotiated with particular health care providers was “notably lacking.”

“Until such provider-specific quality and cost data become more widely-available,” GAO said, “the…goal of having enrollees make health care purchase decisions based on an informed assessment of the quality/cost trade-offs may not be fully realized.”

NTEU is the largest independent federal union, representing some 150,000 employees in 30 agencies and departments.