Will health savings accounts replace ACA subsidies for some Americans?

By Ken Alltucker | Originally posted on USA Today

Created more than two decades ago, health savings accounts are a popular way for consumers to get tax breaks while saving for medical expenses.

But could these accounts take on a larger role in how U.S. consumers pay for and get health care? Senate Republicans have proposed just that. They want to give eligible Americans up to $1,500 to fund health savings accounts rather than extend COVID-19 pandemic-era subsidies that made Affordable Care Act health insurance less expensive for 22 million Americans.

Health savings accounts are commonly used among workers who get health insurance through an employer. As of mid-2025, a national survey showed U.S. consumers had 40 million health savings accounts with $159 billion in deposits, a 16% surge in savings from a year before.

Those figures show an increasing share of Americans rely on health savings accounts to save for unexpected medical expenses, said Scott Cutler, CEO of HealthEquity, which offers health savings accounts.

"We have an affordability crisis for health care in America," Cutler said. "Half of Americans can't afford a $500 medical bill, so having a safety net that grows over time, that you can use for medical expenses, helps Americans be more prepared."