What is a commonly cited con of HSAs?

• A. Adverse selection
• B. Patients may skip necessary healthcare
• C. Lower out-of-pocket costs
• D. Improved access to care

Answer: (B)

When an HSA is paired with a high-deductible plan, you’re steering patients toward more initial out-of-pocket costs. A common drawback people note is that this setup can lead to skipping or delaying necessary medical care to avoid paying the deductible or other upfront expenses. That behavior can compromise health outcomes and may result in higher costs later if conditions worsen and require more intensive treatment. Adverse selection is a broader insurance-market issue about who chooses which plan, not the direct cost-related hesitation to seek care. Lower out-of-pocket costs and improved access to care are typically seen as benefits of HSAs with HDHPs, not drawbacks. So the cited concern—patients skipping needed care due to higher upfront costs—best captures a real downside of this approach.