“A person on Medicaid who can’t scrounge up $80 on the spot definitely isn’t going to be able to put $80 in an HSA, even over time.”

I agree. That’s why I argued that Republicans’ current plan will leave millions unable to get the healthcare they need, and that for market-based health reform to work, the government would have to help fund HSAs.

Everyone up to the poverty line, or slightly above, would need full government support, with support gradually tapering off as we go up the income scale. Otherwise, they won’t be able to afford insurance or out-of-pocket care.

That’s the difference between prioritizing market-based health reform and prioritizing tax cuts. The former recognizes that healthcare is expensive and millions of Americans can’t afford it. The latter looks like the bills currently under discussion in Congress.