Roy Ramthun explains at National Review Online why the Affordable Care Act means bad news for health savings accounts.

Almost six years to the day after the Affordable Care Act was enacted, the Department of Health and Human Services (HHS) has taken steps to kill health savings accounts (HSAs) in the state health-insurance exchanges. It was bound to happen at some point, although some may be surprised that it took this long. In case you missed it, final regulations published on March 8 will make it impossible to offer HSA-qualified plans in the future. Whether this is by accident or design, the outcome is clear.

Over the past several years, HHS has fended off industry concerns about the availability of HSA-qualified plans in the state exchanges while (a) doing nothing to help consumers identify HSA-qualified plans on the exchanges or (b) provide information to individuals that choose HSA-qualified plans about where to get more information about opening and contributing to an HSA. In the March 8 rule regarding the requirements for health plans that will be offered on the state insurance exchanges for 2017, HHS stated that HSA eligibility was not a meaningful distinction for health plans because consumers can determine whether a plan is HSA-qualified by examining a plan’s cost-sharing amounts. So, it will not require HSA-qualified plans to be designated as such.

In order to figure out exactly how HSAs will be eliminated, one has to sift through a massive, more than 500-page-long rule. This will be accomplished through the new standardized benefit designs for plans offered within the lower three “metal” tiers: Bronze, Silver, and Gold. Yet the proposed rule published last fall gave no hint at just how lethal these standardized plan designs in the final rule would be.

Buried in the details of the final rule are the two main reasons why HSA-qualified plans will not survive:

1) Plans must apply specific deductibles and out-of-pocket limits that are outside the requirements for HSA-qualified plans.

2) Plans must cover services below the deductible that are not considered “preventive care.”