In my next two blog entries, I will outline ways that this fall’s elections will affect issues that are important to our readers. Too often, American politics is portrayed as a horse race, focusing on who’s ahead, who’s behind and who has momentum.

This fixation notwithstanding, the party that crosses the finish line first will produce real consequences on a range of issues. And it’s no mystery that the victors will be the Democrats—at least on Capitol Hill. The White House is still in question.

In the House, the 17-seat Democratic majority could increase by as many as 25 seats. The Republican Party has a branding problem worse than that of New Coke a couple decades ago. For a variety of reasons, the GOP is leaving a bad aftertaste with the American people, which has led to three consecutive Republican losses in recent House special elections.

In the Senate, the picture is equally bright for the Democrats. They are likely to end up with 56 to 58 seats, a sharp increase from the 51 they currently hold.

One outcome of increased Democratic majorities is that consumer-directed health care in general, and health savings accounts in particular, will be under attack.

Democrats oppose HSAs for the same reason they resist individual Social Security accounts. They believe they are emblematic of what they call the Republican preference for an “on-your-own society.” HSAs make people fend for themselves in the health care market, as Social Security accounts would make them do in the retirement market.

An example of the Democratic attitude toward HSAs was on display at a House Ways & Means subcommittee hearing May 14. At the meeting, a Government Accountability Office study of HSAs was released.

It showed that HSAs are growing in popularity. The number of lives they cover has risen from 438,000 in 2004, when they were introduced, to 6.1 million in January.

It also showed that people who indicated HSA activity on their tax returns in 2005 had an average adjusted gross income of $139,000, compared with $57,000 for everyone else. Average contributions were $2,100, while average withdrawals were $1,000.

These statistics fueled the Democratic charge that HSAs are for the “healthy and wealthy.” Here’s what the subcommittee chairman, Rep. Pete Stark, D-California, said in prepared remarks:

“The selection of healthy and wealthy people, if these plans were widely adopted, would lead to a devastating cost increase for all who decided to remain in conventional insurance. These plans simply shift costs and responsibilities to consumers. It will discourage lower- and middle-income people from seeking care when they need it.”

Rep. Dave Camp, R-Michigan, responded that the GAO made a mistake in relying on data from 2005, when HSAs were being rolled out, instead of today, when more than 6 million people use them. He accused the GAO of drawing an “erroneous sweeping conclusion.”

He said that HSAs were instrumental in increasing coverage among employees of small companies. He also cited statistics that showed 45 percent of people using HSAs made less than $45,000.

The Republicans were allowed to invite one witness to the hearing: Wayne Sensor, CEO of Alegent Health in Omaha, Nebraska. Sensor said that his firm’s health costs have dropped 15 percent since he started offering HSAs and other consumer-directed health care to his employees.

But Stark chided Sensor for only contributing $100 when employees open their HSA accounts. “You’re giving the store away there,” he said.

Democrats portrayed HSAs as tax shelters in which wealthy people can keep money away from the IRS until they use it for non-medical reasons after turning 65. Before 65, there is a 10 percent penalty for withdrawals for non-health-related purposes.

Democratic antipathy toward HSAs finds its way into legislation. Last month, the House passed a tax bill that would require stricter IRS reporting requirements for the use of HSAs, a move that HSA advocates say would add cost and complexity to the accounts and could cause employers to drop them.

Most Democrats, including freshmen from conservative districts, voted in favor of the bill. Even though many newly elected members of the party are more conservative than Stark and other Democratic leaders, they probably won’t defend HSAs.

Compelling arguments can be made that HSAs do little to address the needs of the 47 million Americans who lack health care coverage and that they cause low-income Americans to avoid needed care. And it may be that President Bush and the Republicans want to skew the tax code to favor misguided health care policy.

What do you think? Does your company provide HSAs and other forms of consumer-directed health care? Why or why not? Is it effective? I’m curious to know where our readers come down on this heated congressional debate.