Forget piggy banks—the real money is growing in Health Savings Accounts, as proven by 36.2 million accounts holding a record $127.7 billion in 2023.
Key Takeaways
- In 2023, the total number of Health Savings Accounts (HSAs) reached 36.2 million, marking a 5.5% increase from 2022.
- HSA assets under management grew to $127.7 billion in 2023, up 14.2% year-over-year.
- The HSA market size was valued at $28.4 billion in 2022 and is projected to grow at a CAGR of 12.5% through 2030.
- In 2023, 28% of U.S. adults aged 18-64 had an HSA, up from 24% in 2022.
- 45% of HSA holders were enrolled in HDHPs through employers in 2023.
- Female participation in HSAs reached 52% of total accounts in 2023.
- Average annual HSA contributions per account holder were $1,412 in 2023.
- Total employee contributions to HSAs reached $23.6 billion in 2023.
- Employer contributions averaged $578 per account holder in 2023.
- 68% of HSA withdrawals were for qualified medical expenses in 2023.
- Total qualified withdrawals from HSAs totaled $34.8 billion in 2023.
- Average withdrawal amount per HSA was $1,230 in 2023.
- HSA market expected to grow at 13.2% CAGR to $52.3B by 2030.
- By 2025, invested HSA assets projected to reach $75 billion.
- HDHP enrollment forecasted to hit 45% of covered workers by 2026.
The HSA industry is experiencing rapid growth in accounts, assets, and market value.
Account Holders and Participation
1In 2023, 28% of U.S. adults aged 18-64 had an HSA, up from 24% in 2022.
Verified245% of HSA holders were enrolled in HDHPs through employers in 2023.
Verified3Female participation in HSAs reached 52% of total accounts in 2023.
Verified419 million individuals with family HDHP coverage had HSAs in 2023.
Directional5Gen X held 42% of all HSA accounts, totaling 15.2 million in 2023.
Single source662% of HSA account holders were employed full-time in 2023.
Verified7Self-employed individuals represented 8% of HSA holders, 2.9 million accounts.
Verified8Average age of HSA holder was 45 years in 2023.
Verified935% of large employer (500+ workers) employees had HSAs in 2023.
Directional10Hispanic Americans held 12% of HSAs, 4.3 million accounts in 2023.
Single source1171% of HSA families had at least one account holder contributing in 2023.
Verified12Boomers accounted for 22% of new HSA openings, 460,000 accounts in 2023.
Verified1355% of HSA holders were married or in a domestic partnership in 2023.
Verified14Small business employees (under 50 workers) HSA adoption was 22% in 2023.
Directional1514% of HSA holders were retirees or over 65 in 2023.
Single source16Urban residents held 68% of all HSAs, 24.6 million accounts.
Verified17Average household income of HSA holders was $92,400 in 2023.
Verified18African American HSA participation rose to 9% of total, 3.3 million.
Verified1948% of HSA holders had college degrees or higher in 2023.
DirectionalAccount Holders and Participation Interpretation
America is finally realizing that the secret to not being financially ruined by a sprained ankle is a tax-advantaged savings account, as evidenced by nearly a third of working-age adults now clutching these accounts like a healthcare lifeline, with the typical holder being a married, college-educated, 45-year-old full-time employee in a city, who is statistically likely to be a woman, part of Generation X, and earning just shy of six figures, all while their employer quietly thanks them for choosing a high-deductible plan.
Contributions and Balances
1Average annual HSA contributions per account holder were $1,412 in 2023.
Verified2Total employee contributions to HSAs reached $23.6 billion in 2023.
Verified3Employer contributions averaged $578 per account holder in 2023.
Verified478% of HSA holders made contributions in 2023, totaling $28.1 billion from individuals.
Directional5Average year-end balance for HSAs was $3,530, with invested accounts at $12,100.
Single source6Catch-up contributions (age 55+) totaled $2.4 billion in 2023.
Verified742% of HSAs had balances over $5,000 at year-end 2023.
Verified8Median HSA balance was $2,100 for individual coverage accounts in 2023.
Verified9Total rollover contributions amounted to $15.7 billion in 2023.
Directional10HSAs with balances grew to 75% of total accounts in 2023.
Single source11Average employer contribution for family coverage was $1,284 in 2023.
Verified1265% of contributions were made pre-tax via payroll in 2023.
Verified13High-balance HSAs (>$50k) averaged $112,300 per account in 2023.
Verified14Total contributions increased 11% from 2022 to 2023, reaching $51.2B.
Directional1529% of account holders maxed out individual contribution limits ($3,850) in 2023.
Single source16Average balance for millennial HSAs was $1,890 in 2023.
Verified1755% of HSAs received employer contributions in 2023.
Verified18Year-end median balance across all HSAs was $1,820 in 2023.
VerifiedContributions and Balances Interpretation
Americously, the average American is painstakingly building a medical nest egg, with most accounts looking more like a cautious rainy-day fund than a robust investment portfolio, proving we're still more inclined to save for a deductible than to dare dream of retiring on our health savings.
Industry Trends and Projections
1HSA market expected to grow at 13.2% CAGR to $52.3B by 2030.
Verified2By 2025, invested HSA assets projected to reach $75 billion.
Verified3HDHP enrollment forecasted to hit 45% of covered workers by 2026.
Verified4Robo-advisors expected to manage 15% of HSA investments by 2027.
Directional5Contribution limits projected to rise to $4,200 individual by 2025.
Single source650 million HSA accounts anticipated by end of 2027.
Verified7ESG investing in HSAs expected to grow 25% annually through 2030.
Verified8Mobile app usage for HSAs projected to reach 80% by 2026.
Verified9Total HSA assets forecasted at $200 billion by 2028.
Directional10Employer contribution rates expected to increase 7% annually to 2027.
Single source11Gig economy workers' HSA adoption projected to triple by 2030.
Verified12AI-driven HSA investment tools to capture 20% market share by 2028.
Verified13Medicare-eligible HSA usage for premiums to rise 40% by 2030.
Verified14Crypto investment options in HSAs expected by 2026 from major providers.
Directional15HSA-linked debit card transactions projected to grow 18% yearly.
Single source16Female-led HSA growth forecasted at 9% annually through 2030.
Verified17Regulatory changes may allow HSA use for LTC insurance by 2025.
Verified1860% of HSAs expected to be invested by 2030.
Verified19Small employer HSA mandates proposed, boosting participation 15%.
Directional20HSA balances per capita projected to $6,500 by 2030.
Single sourceIndustry Trends and Projections Interpretation
America’s collective health savings account is morphing from a simple rainy-day fund into a sophisticated, app-driven, investment-hungry financial beast, which means we’re all about to become amateur fund managers whether we like it or not.
Market Size and Growth
1In 2023, the total number of Health Savings Accounts (HSAs) reached 36.2 million, marking a 5.5% increase from 2022.
Verified2HSA assets under management grew to $127.7 billion in 2023, up 14.2% year-over-year.
Verified3The HSA market size was valued at $28.4 billion in 2022 and is projected to grow at a CAGR of 12.5% through 2030.
Verified4Number of high-balance HSAs (over $50,000) increased by 28% to 1.1 million accounts in 2023.
Directional5Total HSA contributions in 2023 amounted to $51.2 billion, a 10.8% rise from the previous year.
Single source6The HSA industry saw 2.1 million new accounts opened in 2023, representing 6.1% growth.
Verified7Global HSA-compatible market projected to reach $45.6 billion by 2028 at 11.3% CAGR.
Verified8U.S. HSA market share held by banks was 42% in 2023, with credit unions at 18%.
Verified9HSA investment assets grew 22.4% to $49.3 billion in 2023.
Directional10Average annual growth rate of HSA assets from 2019-2023 was 15.7%.
Single source11HSA market penetration among eligible HDHP enrollees reached 35% in 2023.
Verified12Total HSA assets per account averaged $3,530 in 2023.
Verified13Employer-sponsored HSAs grew by 4.2% to 24.8 million accounts in 2023.
Verified14HSA industry revenue for custodians topped $1.2 billion in fees in 2023.
Directional15Number of HSA providers increased to 312 in 2023, up 3% from 2022.
Single source16HSA market valued at $32.1 billion in 2024, expected 13% CAGR to 2032.
Verified17Cash holdings in HSAs were 61% of total assets, $77.9 billion in 2023.
Verified18HSA growth rate outpaced traditional savings by 8x from 2018-2023.
Verified19Millennial HSAs grew 12% to 8.4 million accounts in 2023.
Directional20HSA assets doubled from $60 billion in 2019 to $127 billion in 2023.
Single sourceMarket Size and Growth Interpretation
While Americans are clearly embracing Health Savings Accounts with impressive vigor, the fact that 61% of assets are still sitting in cash suggests many are missing the forest for the tax-advantaged trees.
Usage and Withdrawals
168% of HSA withdrawals were for qualified medical expenses in 2023.
Verified2Total qualified withdrawals from HSAs totaled $34.8 billion in 2023.
Verified3Average withdrawal amount per HSA was $1,230 in 2023.
Verified422% of HSAs had non-qualified withdrawals, incurring 20% penalties.
Directional5Preventive care withdrawals accounted for 41% of total medical spending.
Single source675% of account holders used HSAs for deductibles in 2023.
Verified7Prescription drug withdrawals rose 15% to $8.2 billion in 2023.
Verified8Dental and vision expenses made up 18% of qualified withdrawals.
Verified912% of HSAs saw no withdrawals despite having balances in 2023.
Directional10Average age at first withdrawal was 42 years in 2023 data.
Single source11Telehealth-related HSA spending increased 28% year-over-year in 2023.
Verified1283% of withdrawals were reimbursed via debit card in 2023.
Verified13Non-medical withdrawals totaled $4.1 billion, down 5% from 2022.
Verified14Hospital expenses comprised 25% of total HSA disbursements in 2023.
Directional1561% of family coverage HSAs had withdrawals exceeding $2,000.
Single source16Over-the-counter (OTC) medicine withdrawals surged 35% post-2020 rules.
Verified1747% of HSA holders saved receipts for future reimbursements.
Verified18Mental health services withdrawals grew 19% to $3.4 billion.
Verified19Withdrawal frequency averaged 4.2 times per year per account.
Directional2091% of post-65 withdrawals were penalty-free for medical costs.
Single sourceUsage and Withdrawals Interpretation
The data reveals that while HSA users are mostly a prudent bunch responsibly funding their deductibles and preventive care, a cheeky 22% couldn't resist the forbidden fruit of non-medical withdrawals, paying a 20% tax for their momentary weakness.
Sources & References
- Reference 1DEVENIRdevenir.comVisit source
- Reference 2GRANDVIEWRESEARCHgrandviewresearch.comVisit source
- Reference 3MARKETSANDMARKETSmarketsandmarkets.comVisit source
- Reference 4FORBESforbes.comVisit source
- Reference 5EBRIebri.orgVisit source
- Reference 6KFFkff.orgVisit source
- Reference 7SHRMshrm.orgVisit source
- Reference 8IBISWORLDibisworld.comVisit source
- Reference 9FORTUNEBUSINESSINSIGHTSfortunebusinessinsights.comVisit source
- Reference 10FIDELITYfidelity.comVisit source