State legislators' knowledge and perceptions of medical savings accounts and the United States health care system: Identifying future compromises to health care reform

As researchers, policymakers and employers begin focusing on consumer driven health plan models and medical savings accounts (MSAs), a better understanding of the political viability of such reform initiatives is necessary. The purpose of this study was to survey state legislators' knowledge and perceptions of medical savings accounts (MSAs) and the U.S. health care system in order to identify potential future compromises to health care reform. In February 2004, 201 state legislators from nine states (Alaska, Arizona, Florida, Hawaii, Iowa, Maryland, Massachusetts, Minnesota and Washington) participated in an on-line survey. The findings from this study revealed significant differences between Republican and Democratic state legislators in their attitudes towards MSAs, level of satisfaction of the U.S. health care system, and overall perceptions of the current and future health care systems. Republican state legislators were 24 times more likely to support MSAs than Democrats. Results also indicated the following three areas had possible bipartisan support for future initiatives: making individuals aware of the actual costs of health care services, providing equitable access to health care services for all individuals, and providing equal tax treatment for those individuals without employer-sponsored health insurance.