Wake Forest Law Review, Vol. 40, No. 4 (2005), pp. 1087-1123


With over one year having passed since the Medicare Modernization Act ("MMA") authorized the creation of the first individual Health Savings Accounts ("HSA"), this Article reviews the context, structure, promise, and impact of this new type of tax-advantaged account. The Article begins by briefly reviewing the context of this reform, documenting what both Presidents Clinton and Bush noted about rising costs and decreasing access. The Article then reviews the HSA legislation itself, H.R. 2596, and summarizes how HSAs operate. Part IV of this Article reviews the claims made for HSAs when H.R. 2596 passed as part of the MMA. Part V takes a preliminary look at the impact of HSAs one year after their creation. The Article concludes that HSAs represent, at most, a small piece of the overall health care reform puzzle.