As they continue to grow, Health Savings Accounts face considerable challenges from President Obama's proposed healthcare initiatives.

Projections made by this newsletter's parent, Information Strategies, Inc. (ISI) estimate that by the end of January 2010, more than 7.8 million accounts will be opened, covering 15 million Americans.

At the same time, average costs for total HSA costs, premiums and payments will show a significant difference from more traditional plans.

Nonetheless, new hurdles to growth are expected in legislation now working its way through Congress.

Perhaps most damaging to providers will be greater substantiation requirements, which to date havebeen minimal.

Said one official from the Credit Union industry, "this issue will make it all but impossible for many smaller institutions to continue offering HSA accounts".

Another industry stakeholder said "substantiation will drive many smaller financial institutions out of the sector".  ISI estimates that more than 2,300 financial institutions now offer HSA accounts.