HSA assets under management reached $127.7 billion in 2023, growing 14.2% year over year as the total number of accounts rose to 36.2 million. Participation also expanded, with 28% of U.S. adults aged 18 to 64 holding an HSA in 2023. The figures connect who has HSAs, how much people contribute, and how balances build over time.
Key Takeaways
- In 2023, 28% of U.S. adults aged 18-64 had an HSA, up from 24% in 2022.
- Average annual HSA contributions per account holder were $1,412 in 2023.
- HSA market expected to grow at 13.2% CAGR to $52.3B by 2030.
- In 2023, the total number of Health Savings Accounts (HSAs) reached 36.2 million, marking a 5.5% increase from 2022.
- 68% of HSA withdrawals were for qualified medical expenses in 2023.
HSAs continue to grow as more consumers use tax advantages to save for future healthcare expenses.
Related reading
01 · Category
Account Holders And Participation19 stats
01
In 2023, 28% of U.S. adults aged 18-64 had an HSA, up from 24% in 2022.
02
45% of HSA holders were enrolled in HDHPs through employers in 2023.
03
Female participation in HSAs reached 52% of total accounts in 2023.
04
19 million individuals with family HDHP coverage had HSAs in 2023.
05
Gen X held 42% of all HSA accounts, totaling 15.2 million in 2023.
06
62% of HSA account holders were employed full-time in 2023.
07
Self-employed individuals represented 8% of HSA holders, 2.9 million accounts.
08
Average age of HSA holder was 45 years in 2023.
09
35% of large employer (500+ workers) employees had HSAs in 2023.
10
Hispanic Americans held 12% of HSAs, 4.3 million accounts in 2023.
11
71% of HSA families had at least one account holder contributing in 2023.
12
Boomers accounted for 22% of new HSA openings, 460,000 accounts in 2023.
13
55% of HSA holders were married or in a domestic partnership in 2023.
14
Small business employees (under 50 workers) HSA adoption was 22% in 2023.
15
14% of HSA holders were retirees or over 65 in 2023.
16
Urban residents held 68% of all HSAs, 24.6 million accounts.
17
Average household income of HSA holders was $92,400in 2023.
18
African American HSA participation rose to 9% of total, 3.3 million.
19
48% of HSA holders had college degrees or higher in 2023.
Interpretation
Account Holders And Participation Interpretation
In 2023, HSA ownership rose to 28% of U.S. adults aged 18 to 64, with 62% of account holders employed full-time, underscoring that participation is increasingly becoming mainstream among working Americans.
02 · Category
Contributions And Balances18 stats
01
Average annual HSA contributions per account holder were $1,412in 2023.
02
Total employee contributions to HSAs reached $23.6 billion in 2023.
03
Employer contributions averaged $578per account holder in 2023.
04
78% of HSA holders made contributions in 2023, totaling $28.1 billion from individuals.
05
Average year-end balance for HSAs was $3,530,with invested accounts at $12,100.
06
Catch-up contributions (age 55+) totaled $2.4 billion in 2023.
07
42% of HSAs had balances over $5,000 at year-end 2023.
08
Median HSA balance was $2,100for individual coverage accounts in 2023.
09
Total rollover contributions amounted to $15.7 billion in 2023.
10
HSAs with balances grew to 75% of total accounts in 2023.
11
Average employer contribution for family coverage was $1,284in 2023.
12
65% of contributions were made pre-tax via payroll in 2023.
13
High-balance HSAs (>$50k) averaged $112,300 per account in 2023.
14
Total contributions increased 11% from 2022 to 2023, reaching $51.2B.
15
29% of account holders maxed out individual contribution limits ($3,850) in 2023.
16
Average balance for millennial HSAs was $1,890in 2023.
17
55% of HSAs received employer contributions in 2023.
18
Year-end median balance across all HSAs was $1,820in 2023.
Interpretation
Contributions And Balances Interpretation
In the Contributions And Balances category, HSA ownership showed strong participation with 78% of holders contributing $28.1 billion in 2023 while balances were growing, averaging $3,530 year end and rising to $12,100 for invested accounts.
03 · Category
Industry Trends And Projections20 stats
01
HSA market expected to grow at 13.2% CAGR to $52.3B by 2030.
02
By 2025, invested HSA assets projected to reach $75 billion.
03
HDHP enrollment forecasted to hit 45% of covered workers by 2026.
04
Robo-advisors expected to manage 15% of HSA investments by 2027.
05
Contribution limits projected to rise to $4,200individual by 2025.
06
50 million HSA accounts anticipated by end of 2027.
07
ESG investing in HSAs expected to grow 25% annually through 2030.
08
Mobile app usage for HSAs projected to reach 80% by 2026.
09
Total HSA assets forecasted at $200 billion by 2028.
10
Employer contribution rates expected to increase 7% annually to 2027.
11
Gig economy workers' HSA adoption projected to triple by 2030.
12
AI-driven HSA investment tools to capture 20% market share by 2028.
13
Medicare-eligible HSA usage for premiums to rise 40% by 2030.
14
Crypto investment options in HSAs expected by 2026 from major providers.
15
HSA-linked debit card transactions projected to grow 18% yearly.
16
Female-led HSA growth forecasted at 9% annually through 2030.
17
Regulatory changes may allow HSA use for LTC insurance by 2025.
18
60% of HSAs expected to be invested by 2030.
19
Small employer HSA mandates proposed, boosting participation 15%.
20
HSA balances per capita projected to $6,500by 2030.
Interpretation
Industry Trends And Projections Interpretation
Health Savings Accounts are set for strong expansion as projections point to 50 million accounts by end of 2027 and assets reaching $75 billion by 2025, supported by HDHP enrollment rising to 45% of covered workers by 2026.
More related reading
04 · Category
Market Size And Growth20 stats
01
In 2023, the total number of Health Savings Accounts (HSAs) reached 36.2 million, marking a 5.5% increase from 2022.
02
HSA assets under management grew to $127.7 billion in 2023, up 14.2% year-over-year.
03
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.
04
Number of high-balance HSAs (over $50,000) increased by 28% to 1.1 million accounts in 2023.
05
Total HSA contributions in 2023 amounted to $51.2 billion, a 10.8% rise from the previous year.
06
The HSA industry saw 2.1 million new accounts opened in 2023, representing 6.1% growth.
07
Global HSA-compatible market projected to reach $45.6 billion by 2028 at 11.3% CAGR.
08
U.S. HSA market share held by banks was 42% in 2023, with credit unions at 18%.
09
HSA investment assets grew 22.4% to $49.3 billion in 2023.
10
Average annual growth rate of HSA assets from 2019-2023 was 15.7%.
11
HSA market penetration among eligible HDHP enrollees reached 35% in 2023.
12
Total HSA assets per account averaged $3,530in 2023.
13
Employer-sponsored HSAs grew by 4.2% to 24.8 million accounts in 2023.
14
HSA industry revenue for custodians topped $1.2 billion in fees in 2023.
15
Number of HSA providers increased to 312 in 2023, up 3% from 2022.
16
HSA market valued at $32.1 billion in 2024, expected 13% CAGR to 2032.
17
Cash holdings in HSAs were 61% of total assets, $77.9 billion in 2023.
18
HSA growth rate outpaced traditional savings by 8x from 2018-2023.
19
Millennial HSAs grew 12% to 8.4 million accounts in 2023.
20
HSA assets doubled from $60 billion in 2019 to $127 billion in 2023.
Interpretation
Market Size And Growth Interpretation
In the Market Size And Growth category, the HSA industry expanded strongly in 2023 with total assets under management reaching $127.7 billion and contributions rising to $51.2 billion, while the market size is expected to grow from $28.4 billion in 2022 at a 12.5% CAGR through 2030.
05 · Category
Usage And Withdrawals20 stats
01
68% of HSA withdrawals were for qualified medical expenses in 2023.
02
Total qualified withdrawals from HSAs totaled $34.8 billion in 2023.
03
Average withdrawal amount per HSA was $1,230in 2023.
04
22% of HSAs had non-qualified withdrawals, incurring 20% penalties.
05
Preventive care withdrawals accounted for 41% of total medical spending.
06
75% of account holders used HSAs for deductibles in 2023.
07
Prescription drug withdrawals rose 15% to $8.2 billion in 2023.
08
Dental and vision expenses made up 18% of qualified withdrawals.
09
12% of HSAs saw no withdrawals despite having balances in 2023.
10
Average age at first withdrawal was 42 years in 2023 data.
11
Telehealth-related HSA spending increased 28% year-over-year in 2023.
12
83% of withdrawals were reimbursed via debit card in 2023.
13
Non-medical withdrawals totaled $4.1 billion, down 5% from 2022.
14
Hospital expenses comprised 25% of total HSA disbursements in 2023.
15
61% of family coverage HSAs had withdrawals exceeding $2,000.
16
Over-the-counter (OTC) medicine withdrawals surged 35% post-2020 rules.
17
47% of HSA holders saved receipts for future reimbursements.
18
Mental health services withdrawals grew 19% to $3.4 billion.
19
Withdrawal frequency averaged 4.2 times per year per account.
20
91% of post-65 withdrawals were penalty-free for medical costs.
Interpretation
Usage And Withdrawals Interpretation
In 2023, 68% of HSA withdrawals were for qualified medical expenses totaling $34.8 billion, showing that most usage and withdrawals are still driven by eligible health costs rather than non-qualified spending.
report visual · Key figures
HSA adoption is rising
The share of U.S. adults with HSAs increased year over year, indicating continued adoption growth.
28%
In 2023, 28% of U.S. adults aged 18-64 had an HSA, up from 24% in 2022.
5.5%
In 2023, the total number of Health Savings Accounts (HSAs) reached 36.2 million, marking a 5.5% increase from 2022.
11%
Total contributions increased 11% from 2022 to 2023, reaching $51.2B.
Reference
Cite This Report
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APA
Priyanka Sharma. (2026, February 13). Health Savings Account Industry Statistics. Gitnux. https://gitnux.org/health-savings-account-industry-statistics
MLA
Priyanka Sharma. "Health Savings Account Industry Statistics." Gitnux, 13 Feb 2026, https://gitnux.org/health-savings-account-industry-statistics.
Chicago
Priyanka Sharma. 2026. "Health Savings Account Industry Statistics." Gitnux. https://gitnux.org/health-savings-account-industry-statistics.
Sources & references
10 datasets cited across this report · attribution is report-level