To lower health care costs, Health Savings Accounts (HSAs) offer tax incentives encouraging people to trade off current consumption against future consumption. This paper tests whether consumers use HSAs as self-insurance over the life cycle. Using administrative data from a large employer and a regression discontinuity design, I estimate the marginal propensity to consume from HSA assets is 0.85 and reject the neoclassical benchmark of 0. Comparisons with 401(k) saving show most employees do not treat HSA money as fungible with retirement savings. In this setting, HSAs did not reduce health spending and instead increased the share that was financed tax-free. (JEL D15, D82, G22, G51, I13)

中文翻译：

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健康保险设计符合储蓄激励：消费者对复杂合同的反应

为了降低医疗保健成本，健康储蓄账户 (HSA) 提供税收优惠，鼓励人们在当前消费与未来消费之间进行权衡。本文测试了消费者是否在整个生命周期中使用 HSA 作为自我保险。使用来自大型雇主的管理数据和回归不连续设计，我估计 HSA 资产的边际消费倾向为 0.85，并拒绝新古典主义基准 0。与 401(k) 储蓄的比较表明，大多数员工并不将 HSA 资金视为可替代的与退休储蓄。在这种情况下，HSA 并没有减少卫生支出，而是增加了免税资助的份额。(JEL D15、D82、G22、G51、I13)