Not the next IRA: how health savings accounts shape public opinion

Scholars suspect that public policies affect public opinion, but the empirical evidence is mixed, and contemporary theories advance offsetting predictions. This study examines two allegedly similar private investment account programs that differ in politically relevant ways. Statistical analyses show that owners of Individual Retirement Accounts (IRAs) and Health Savings Accounts (HSAs) experience policy feedback effects, but in opposite directions. More specifically, matched comparisons of respondents in a national survey indicate that IRA participants are more likely to favor Social Security privatization than individuals without IRAs. In contrast, HSA participants are less likely to prefer consumer-driven health coverage in which individuals are empowered to make choices. Overall, the findings suggest that policies alter public opinion preferences but that the effects depend on programmatic design and performance.