OPM acknowledged that the introduction of HSAs “has been the source of both great excitement and significant concern among both employees and stakeholders.” One of those concerns was that the arrangement, with its age cutoff, would violate FEHB law prohibiting distinctions in benefits by age. In response, OPM said that carriers offering an HSA must also offer a “health reimbursement account” of equivalent value or other alternative benefits for those ineligible for an HSA because of their age. An HRA may be used for similar medical expenses as an HSA, plus Medicare premiums. The call letter did not directly address another major concern that arose, that HSAs, with their low premiums, would draw off healthier enrollees who expect to have to pay relatively little in deductibles, leaving other enrollees with higher premiums. OPM said in recent House testimony that it doesn’t expect such “adverse selection” to be a significant problem because it expects relatively few eligible persons would enroll in such plans, at least at first.