WASHINGTON -- Medical savings accounts are tax shelters for the wealthy or a panacea for uninsured Americans, depending on who you talk to. With a government test of the accounts set to end this year, Congress must decide which description fits and whether to extend the plan to more Americans.
MSAs, as they are known, allow people to set aside tax-deductible savings to pay routine doctor bills. Account holders get companion health insurance policies -- as protection against expensive care -- that have high deductibles but can cost less than being in a health plan.
They are available to self-employed people and small companies that offer them as an employee benefit under a pilot program established by Congress in 1997.
Kay Heine, a self-employed mother of three, was going without insurance because she couldn't afford the premiums when she decided to try an MSA. Now she pays $144 a month -- less than half of what she would have paid for major medical coverage -- and squirrels money away for her children's checkups and dental bills.
''When you have kids, that really helps a lot,'' said Heine, a single mom from Wisconsin.
Republicans and specialty insurance firms believe MSAs are a sure way to provide low-cost health coverage to millions of Americans who don't have medical insurance and will help more break free of managed care organizations. With the accounts, consumers are free to choose their own doctors without a middleman or gatekeeper.
MSAs can be especially beneficial to healthy people with low doctor bills, marketers say. Not only are premiums lower, but any money not used for medical expenses can be rolled over.
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