Personal Health Accounts Empower Medicaid Recipients

As Michael Sherraden pointed out 20 years ago in his book Assets and the Poor: A New American Welfare Policy, the key to getting ahead is not income but assets. People play better and smarter when they have a stake in the system.

According to research, assets not only provide financial security, but they cause people to lead more stable lives, think in longer time frames, be more involved in community affairs, and have more hope for the future.

While many government programs discourage asset accumulation, causing low-income individuals to miss the psychological and tangible benefits of asset building, some states are trying a new approach. South Carolina is testing personal health accounts in a pilot project for Medicaid recipients. Participants get high-deductible insurance paired with savings accounts for medical expenses that aren’t covered by insurance, all funded by Medicaid. When program recipients increase their income and no longer qualify for Medicaid, they keep the balance in their health accounts.

The program realizes the benefits that higher income individuals (and businesses) have already seen from switching to high deductible insurance paired with health savings accounts: People make smarter decisions about what health care they need or want when they have “skin in the game.” That “skin” is the balance of their health savings account.

Isn’t it time that Oregon think outside the box to incorporate asset building into its safety nets?

Christina Martin is Director of the Asset Ownership Project at Cascade Policy Institute, Oregon’s free market public policy research organization.