GAO Reports Highlight CMS Directive, Health Savings Accounts, and State Budgets

The Government Accountability Office has published three reports of relevance to state health care reform:

• Congressional Review Act: Applicability to CMS Letter on State Children's Health Insurance Program found that the Centers for Medicare and Medicaid Services’ August 17 directive qualifies as a rule as defined by the Congressional Review Act, not a policy statement as CMS contends, and, as such, should have been submitted for public testimony and congressional approval.
  
• Health Savings Accounts: Participation Grew, and Many HSA-Eligible Plan Enrollees Did Not Open HSAs while Individuals Who Did Had Higher Incomes found that individuals enrolled in high-deductible health plans with health savings accounts (HSAs) had an adjusted gross income more than twice that of other taxpayers. In addition, the report found that contributions to HSAs far outpaced withdrawals, and nearly half of individuals who were eligible to open an HSA did not do so.
  
• State and Local Governments: Growing Fiscal Challenges Will Emerge during the Next 10 Years found that increasing health care expenditures will increasingly frustrate efforts to balance state budgets and that states will have to move beyond sole reliance on tax increases or expenditure cuts to find solutions.