Why HSA's are a slight improvement on MSA plans they still lack immediate benefits for folks that are most in need of the medical coverage. Yes you can save funds in a IRA like plan through a HSA but you are also responsible for all of the cost until you reach a high deductible which on average has hovered right around 3k for a family. In a nutshell the respons to HSA's has been far below the thought on what the demand would be and employers have yet to flock to these plans as they are confusing to people that have had traditional coverage, PPO's or HMO coverages. Personally, I have a HSA plan through Anthem Blue Cross and Blue Shield but I rarely ever have to seek medical treatment (knock on wood) but I like the savings feature, but I would not recommend the coverage for a person whom has limited income as they would get no immediate benefits until they reach the decutible thus they would have more out of their pockets.