HSA Day Report: Where Do Health Savings Accounts Stand in Their Mid-22nd Year?
By William G. Stuart | Originally posted on Health Savings Academy
Health Savings Accounts continue to grow. That's good news for consumers.
Happy HSA Day! Yes, it is a recognized event, thanks to the 2018 efforts of WEX Inc., a leading Health Savings Account technology platform and non-bank administrator. The date falls conveniently at the mid-point in the calendar between the due dates of federal income taxes and the beginning of what is the annual open-enrollment period for close to half of all Americans who receive their medical coverage through their employer.
The state of the market is impressive, as highlighted in the most recent Devenir Research semi-annual market survey. All evidence points to growth as more hard-working American families integrate these accounts into their strategy to secure their financial future.
The numbers tell an impressive story. But numbers don't tell stories - the stories of Health Savings Account owners who use terms like "peace of mind," "a safety net," "control," and "a hedge against the future" when they are asked to describe the feelings that they have toward their Health Savings Accounts.
However, those 40 million stories don't fit neatly into a LinkedIn article. So, we will have to settle for examining the impressive quantitative performance of Health Savings Accounts through the first half of 2025.
Number of Accounts
Total Health Savings Accounts have grown modestly - about 5% - since July 2024. This rate is consistent with the past few years, as the five-year compound annual growth rate (CAGR) is 6.2%. Growth has slowed because most employers either have sponsored HSA-qualified plans for years or have no plans to offer them, and most employees who have access have either enrolled or have no plans to do so.
In the nongroup market, HSA-qualified plan enrollment is low. The tight actuarial ranges that plans must meet in federal- and state-facilitated marketplaces ("exchanges") are squeezing HSA-qualified plans as an option. Fewer than 2% of all plans in these marketplaces are HSA-qualified. The One Big, Beautiful Bill Act designated Bronze and Catastrophic plans as HSA-qualified, which opens the menu to multiple HSA-qualified plans for most nongroup enrollees. Low-income nongroup shoppers who qualify for Cost-Sharing Reduction (SCR) subsidies - direct payments to insurers to offset their deductible and coinsurance expenses - can collect those subsidies if they choose a Silver plan, so they do not have practical access to a Health Savings Account.