![Doctor holding hands with patient](/sites/cato.org/files/styles/optimized/public/2021-09/202109_hsa4.jpg?itok=wMk6jsm6) 

# Making Health Savings Accounts Work for Everyone 

At a Glance 

The most important health care right is the right to make one’s own health decisions. An essential part of that right is the right to control one’s income.

For 100 years, Congress has threatened workers with higher taxes unless they let an employer control a large portion of their income and choose their health insurance. Congress penalizes workers for exercising their rights to choose their health insurance and make their own health care decisions. This tax “break” coerces workers into letting employers control roughly $1 trillion of their earnings and their health insurance.

Workers have a right to control that money and to make their own health care decisions without government penalizing them. Government should not bestow preferential tax treatment on any particular uses of income.

At present, health savings accounts free only a small share of workers to control only a small share of those earnings. Congress can restore health care rights and improve health care by making health savings accounts work for everyone.

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#### Featured Content 

[![Person with tax documents and calculator](/sites/cato.org/files/styles/content_teaser/public/2022-05/202205_taxes3.jpg?itok=tCHactyt)](https://www.cato.org/policy-analysis/end-tax-exclusion-employer-sponsored-health-insurance-return-1-trillion-workers-who) 

Study 

## [End the Tax Exclusion for Employer-Sponsored Health Insurance](/policy-analysis/end-tax-exclusion-employer-sponsored-health-insurance-return-1-trillion-workers-who) 

By [Michael F. Cannon](https://www.cato.org/people/michael-f-cannon) 

The tax code threatens workers with $352 billion in taxes unless they let their employers control $1 trillion of their earnings.

[![public-health-services.jpg](/sites/cato.org/files/styles/content_teaser/public/2021-04/public-health-services.jpg?itok=6Y_c_vR3)](https://www.cato.org/commentary/bipartisan-way-lower-costs-restore-health-care-rights) 

Commentary 

### [A Bipartisan Way to Lower Costs and Restore Health Care Rights](/commentary/bipartisan-way-lower-costs-restore-health-care-rights) 

By [Michael F. Cannon](https://www.cato.org/people/michael-f-cannon) 

HSAs offer an opportunity to improve health care without partisan sniping. Both parties should seize it.

[![Black doctor places stethoscope on a smiling black child](/sites/cato.org/files/styles/content_teaser/public/2020-11/GettyImages-1147973154_edited.jpg?itok=3PRey_VL)](https://www.cato.org/blog/new-cato/yougov-survey-health-savings-accounts) 

blog 

### [New Cato/​YouGov Survey on Health Savings Accounts](/blog/new-cato/yougov-survey-health-savings-accounts) 

By [Michael F. Cannon](https://www.cato.org/people/michael-f-cannon) 

Americans do not grasp the extent to which the U.S. tax code violates their health care rights. But they do support restoring those rights by making health savings accounts (HSAs) work for everyone.

[![](/sites/cato.org/files/styles/content_teaser/public/brightcove/videos/images/posters/image_26378.jpg?itok=i2R60Ybv)](https://www.cato.org/multimedia/events/health-savings-accounts-25-years-restoring-patients-rights) 

Events 

### [Health Savings Accounts: 25 Years of Restoring Patients’ Rights](/multimedia/events/health-savings-accounts-25-years-restoring-patients-rights) 

Featuring Brian Blase, John C. Goodman, and [Michael F. Cannon](https://www.cato.org/people/michael-f-cannon) 

At this virtual forum, leading health policy scholars will commemorate the 25th anniversary of this milestone event and discuss how to return to workers every penny of that $900 billion.

[![Doctor and patient](/sites/cato.org/files/styles/content_teaser/public/2021-09/202109_hsa5.jpg?itok=X5bsdw-t)](https://www.cato.org/tax-budget-bulletin/combining-tax-reform-health-care-reform-large-hsas) 

Study 

### [Combining Tax Reform and Health Care Reform with Large HSAs](/tax-budget-bulletin/combining-tax-reform-health-care-reform-large-hsas) 

By [Michael F. Cannon](https://www.cato.org/people/michael-f-cannon) 

Expanded HSAs could reduce health care costs and increase individual choice and control over medical decisions.