If health insurance goes single payer you stop putting money into your (presumably) now non-existent HSA and start paying it in medicare taxes. Depending on how the rates end up you might end up paying more or less. I mean that&#x27;s the end result no matter what your current insurance situation is: you might end up paying more or less. Thats also true no matter what happens in the election or what happens to the ACA. There is no law anyone can pass&#x2F;get passed that will absolutely guarantee every individual in the US has an equal or higher effective take home in 2020.