List of HSA insurers was never created

Gov. Bob McDonnell promised to promote health savings accounts, which are used by those insured to pay for medical expenses, during his 2009 campaign.

Then, he said he would "publish a list of all insurers who offer health savings accounts."

In 2012, we found that this effort was Stalled while the governor waited for the Supreme Court to rule on the constitutionality of the Affordable Care Act, which was passed in 2010 and resulted in major changes to the health care system. And the federal bureaucracy had yet to decide whether HSAs would be viable under the health care reform law.

Paul Fronstin, director of the health research and education program at Employee Benefit Research Institute, said the federal government will permit HSAs.

"And actually, HSAs are likely to get nice bump as a result of the ACA," he said.

Large employers have said they are likely to move to HSAs in their health care plans, Fronstin said. Small employers will typically allow employees to pick plans on a health care exchange based on a certain level of coverage and consumer cost, denoted by different metals -- bronze, silver, gold and platinum. Employees will choose the plan they like from that tier and the plan may include an HSA component. Generally, in an exchange, HSAs would be coupled with a high-deductible health plan.

Under the Affordable Care Act, all plans must put a certain portion toward health care cost, which create some difficulties for HSAs. And all plans must have a baseline of coverage.

State officials are not sure any of the plans in the health care exchange for Virginia include an HSA.

"The uncertainty around the exchange leaves some unknowns about the value of high-deductible plans and whether they are allowable under the exchange," Secretary of Health and Human Resources Bill Hazel said. "We don't know if there will be any or not, so we can't promote them."

Certainly, following through on this promise was fraught with difficulties due to the implementation of the health care reform law. But McDonnell still receives a Promise Broken.