The two principal expenditures of the Affordable Care Act so far include $850 billion for insurance subsidies and a similar outlay for a massive Medicaid expansion. The truth is that Medicaid—a program costing $500 billion a year that rises to $890 billion in 2024—funnels low-income families into substandard coverage. Instead of providing a pathway to excellent health care for poor Americans, ObamaCare’s Medicaid expansion doubles down on their second-class health-care status.

Published studies have shown that pairing HSAs with high-deductible coverage reduceshealth-care costs. Patient spending averages 15% lower in high-deductible plans, with even more savings when paired with HSAs—without any consequent increases in emergency visits or hospitalizations and without a harmful impact on low-income families. Secondarily, wellness programs that HSA holders more commonly use improve chronic illnesses, reduce health claims and save money.

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