A couple of years ago in an effort to lure more health insurers back into its market, New Hampshire allowed its insurers to establish premium levels based on subscriber risk, i.e., age, health status, etc.
Here's the Concord Monitor on what happened and why New Hampshire has just reversed direction:
Before SB 110 took effect, the state operated on a "community rating"system that forbade insurers from rejecting an applicant for health reasons or from basing rates on health status or geography. Once community rating ended, insurers began returning to New Hampshire, just as supporters of the change predicted. They came, however, to cherry-pick, signing up the healthy while using exorbitant quotes to drive away those most likely to need care.
Prices dropped considerably for a small group of employers, primarily those with young and healthy workforces that lived in an area where health-care costs were relatively low. But, according to the state's insurance department, 80 percent of the state's small businesses saw increases, and the rates for nearly half rose by 30 percent or more in one year. Some saw rates rise by 80 percent.
Is there any reason to believe that health savings accounts won't have the same effects?