The TIAA Paul A. Samuelson Award for outstanding scholarly writing on lifelong financial security

Adam Leive of the University of California, Berkeley, won the 2022 TIAA Paul A. Samuelson Award for Outstanding Scholarly Writing on Lifelong Financial Security for his paper “Health Insurance Design Meets Saving Incentives: Consumer Responses to Complex ContractsOpens in a new window” published in American Economic Journal: Applied Economics, 2022. 14(2): 200-227.

Health Savings Accounts (HSAs) were designed to reduce health care spending by exposing consumers to marginal costs while offering tax subsidies that encourage long-term saving. Dr. Leive’s study finds HSAs do not tend to lower health care spending but instead increase the share of costs financed tax-free. Moreover, few consumers treat their HSA money as fungible with retirement savings. 

“Consumers are increasingly responsible for making their own health insurance and saving decisions,” said Leive. “HSAs provide unparalleled incentives to save for lifetime health expenses. Few consumers, however, actually use HSAs in this manner, leaving substantial amounts of money on the table.” 

According to James Choi, professor of finance at Yale University and one of the award judges, “This paper makes two important contributions. On a personal finance level, it shows you're probably using your HSA suboptimally. Fortunately, the tax-minimizing strategy, while counterintuitive, is very easy to implement. And on a policy level, it suggests high-deductible health plans are not achieving their goal of reducing growth in health care costs.”