Health Care Savings Accounts are not replacements for Health Care Insurance.

I've had Health Care Savings Accounts, but, I also had health care insurance for myself and my children. 

The Health Care Saving Accounts were to cover the deductibles, but, the payment of all those deductibles are still the subscriber's responsibilities. Only after the deductibles were paid could the receipts be submitted for reimbursement. I was fortunate enough to have an income that allowed me to pay the deductibles twice. First to establish the health care savings account and then to pay the deductibles to submit for reimbursement. Not all Middle Class families are that fortunate to have that level of disposable income to achieve that outcome.

For those that cannot afford a Health Care Savings Account the expanded Medicaid program is a sincere answer for them. 

There is one other downside to Health Care Savings Accounts and that is correctly estimating the monies that will be paid for deductibles annually. If the submitted receipts do not equal or exceed the amount paid into the Health Care Savings Account that money is lost to the company holding the monies for reimbursement. These are tax free dollars and coming to an accurate amount of monies to be used for deductibles or bills is very important otherwise it does not pay to set up the account.