Legislation to allow consumers to set up medical savings accounts appears to be moving slowly through Congress, but finally moving. Congress has approved a package of small health reforms that would protect those who change jobs or have pre-existing conditions. It includes a provision for MSAs. Republicans and Democrats reached a compromise over MSAs, the tax-deductible accounts as an alternative to group health insurance for people willing to buy high-deductible policies. The deal would create a four-year pilot program, in which MSAs would be available only to the self-employed and those businesses with 50 or fewer workers. Congressional negotiations still must work out details.