By Sally Pipes
Thursday, 02 April 2026 06:07 PM EDT
Rising healthcare costs continue to squeeze household finances. Washington remains divided over how to respond. But new public opinion data suggests patients have a unified solution.
More than eight in 10 voters would react positively to an elected official who believed that “To improve health care, we need to fund patients, not the system,” according to polling from Fund the Patient, a nonprofit organization. That support crosses party lines; similar shares of Democrats, Republicans, and independents feel the same way.
What might such a patient-first policy look like? It starts by expanding access to tax-advantaged health savings accounts (HSAs).
More than 80% of voters agree with this idea. They want control over how they spend their healthcare dollars—rather than deferring to the judgment of their insurance company.
Transforming patients from passive consumers into active shoppers for care has the potential to yield better-quality care at lower costs.
HSAs allow individuals to sock away money for future medical expenses. Unlike traditional savings accounts, HSA contributions are triple-tax-advantaged: deposits are not subject to income tax; the funds grow tax-free; and money can be withdrawn tax-free as long as it goes toward qualified medical expenses.
These tax benefits can add up to real savings for patients. Someone in the 22% tax bracket—a single person with income roughly between $48,000 and $103,000 or a married couple with income between $96,000 and $206,000—can end up saving nearly 30% on anything purchased with money from their HSA.
Crucially, HSAs provide these significant discounts in a way that lets patients—not insurers, government bureaucrats, or hospital administrators—decide how best to spend their healthcare dollars.
Lower out-of-pocket costs and greater patient autonomy aren’t the only reasons to support HSAs. By giving patients more power to shop for care and compare prices among providers, these accounts also introduce market incentives that promise long-term price reductions.
One study of large employers offering consumer-directed health plans combined with HSAs found significant long-term cost reduction—and no evidence of worse health outcomes.
Unfortunately, HSAs remain hampered by strict federal rules that limit both their utility and availability. For instance, until recently, only certain high-deductible insurance plans could be paired with these savings vehicles.
The federal budget bill signed into law by President Trump last July loosened those restrictions to make HSAs compatible with all bronze exchange plans as well as catastrophic plans. It also allowed patients to use HSA funds for direct primary care—a subscription-style service that generally offers patients unlimited access to a primary care physician and certain related services for a flat monthly fee.
Both provisions represent progress. But there is little reason why HSAs shouldn’t be available to Americans with any sort of coverage—or no coverage at all.
By the same token, the long-standing limits on how much patients can contribute to an HSA each year need to go—or at least be raised significantly. This year, individuals are allowed to contribute only $4,400 to their HSAs, while those on family plans can put up to $8,750 away. Those 55 and over can contribute an extra $1,000.
Allowing people to save more money—especially in their younger years, when their ability to save almost certainly eclipses their need for care—will help them prepare for the reality of aging, when medical expenses will begin to grow. It will also empower them to take control of their care in the short term and decide where their healthcare dollars go, both now and in the future.
Put differently, HSAs are a way to fund patients, not the system—exactly what patients say they want.
