With assets skyrocketing to $128.5 billion and millions of new accounts opening each year, the Health Savings Account (HSA) industry has exploded from a niche benefit into a financial juggernaut reshaping how Americans pay for healthcare.
Key Takeaways
- In 2023, the total assets held in Health Savings Accounts (HSAs) in the US reached $128.5 billion, reflecting a 12% year-over-year growth.
- The HSA market size was valued at $45.2 billion in 2022 and is projected to grow to $72.8 billion by 2030 at a CAGR of 6.2%.
- Global HSA and similar accounts managed $150 billion in assets under management as of mid-2023.
- As of 2023, there were 36.8 million HSA accounts in the US.
- HSA enrollment grew by 11% year-over-year to 36.8 million accounts in 2023.
- 28% of US workers with HDHPs had an HSA in 2023.
- As of 2023, average HSA balance was $3,833 across all accounts.
- Total HSA assets grew 13% to $128.5 billion in 2023.
- Invested HSA assets reached $38.4 billion, up 24% from 2022.
- Total employee contributions to HSAs reached $28.4 billion in 2023.
- Average annual employee contribution per HSA was $1,200 in 2023.
- Employer contributions totaled $12.6 billion across all HSAs in 2023.
- In 2023, 65% of HSA funds were spent on qualified medical expenses.
- Average annual withdrawal per HSA was $1,450 in 2023.
- Non-medical withdrawals (taxed + penalty) were 5% of total distributions in 2023.
The HSA industry is rapidly growing in both total assets and user enrollment.
Asset Accumulation
1As of 2023, average HSA balance was $3,833 across all accounts.
Verified2Total HSA assets grew 13% to $128.5 billion in 2023.
Verified3Invested HSA assets reached $38.4 billion, up 24% from 2022.
Verified4Median HSA balance for families was $6,920 in 2023.
Directional5Cash-held HSA assets totaled $90.1 billion in 2023.
Single source6Average invested balance per account was $12,450 in 2023.
Verified7HSA assets in mutual funds amounted to $22.7 billion in 2023.
Verified8Year-end 2023 average balance per account rose 8% to $3,833.
Verified9Total HSA assets per capita among enrollees was $3,490 in 2023.
Directional10ETFs held in HSAs totaled $9.8 billion in assets in 2023.
Single source11Average balance for accounts over 10 years old was $28,500 in 2023.
Verified12HSA assets in fixed-income securities reached $5.2 billion in 2023.
Verified13Million-dollar HSA balances numbered 1,200 in 2023.
Verified14Average annual asset growth rate per HSA was 9.2% from 2018-2023.
Directional15HSA assets allocated to stocks were 35% of invested portfolios in 2023.
Single source16Total rollover contributions to HSAs added $4.1 billion in assets in 2023.
Verified17HSA assets in target-date funds hit $3.6 billion in 2023.
Verified18Female-held HSA average balance was $3,210 vs. $4,560 for males in 2023.
Verified19Regional average: Midwest HSA balances averaged $4,100 in 2023.
Directional20HSA assets growth outpaced inflation by 4.5% in 2023.
Single source21Accounts with balances over $50,000 totaled 150,000 in 2023.
Verified22Average employer seed money contributed $650 per new HSA in 2023.
Verified23HSA assets in alternative investments reached $1.2 billion in 2023.
Verified24Year-over-year asset increase for millennials' HSAs was 15% in 2023.
Directional25Total HSA assets held by top 10 custodians: $105 billion in 2023.
Single source26Average balance growth for family HSAs was 10.2% in 2023.
Verified27HSA assets per enrolled employee averaged $5,200 in large firms in 2023.
VerifiedAsset Accumulation Interpretation
The numbers paint a tale of two savers: while the prudent few are steadily building formidable, investment-powered health nest eggs, the cautious majority are still parking their contributions in cash, leaving billions in potential growth on the table.
Contribution Trends
1Total employee contributions to HSAs reached $28.4 billion in 2023.
Verified2Average annual employee contribution per HSA was $1,200 in 2023.
Verified3Employer contributions totaled $12.6 billion across all HSAs in 2023.
Verified4Average employer contribution per participant was $650 in 2023.
Directional5Total contributions (employee + employer) hit $44.3 billion in 2023.
Single source668% of HSA holders made at least one contribution in 2023.
Verified7Maximum IRA rollover to HSA used by 45,000 accounts, contributing $1.8 billion in 2023.
Verified8Average monthly contribution rate was $150 per active HSA in 2023.
Verified9Employer contribution as % of salary averaged 0.8% in 2023.
Directional10Catch-up contributions (age 55+) totaled $950 million in 2023.
Single source1142% of employers offered matching contributions up to $1,000 in 2023.
Verified12Average contribution for family coverage HSAs was $2,100 in 2023.
Verified13Payroll deduction contributions accounted for 88% of total in 2023.
Verified14Millennials contributed an average of $950 annually to HSAs in 2023.
Directional15Total catch-up eligible contributions grew 12% to $950 million in 2023.
Single source16Small business average employer contribution was $450 per employee in 2023.
Verified17Contribution frequency: 55% monthly, 30% quarterly in 2023.
Verified18Female contributors averaged $1,050 vs. $1,380 for males in 2023.
Verified19Public employers contributed $1.2 billion total to HSAs in 2023.
Directional20Average first-year contribution was $850 per new HSA in 2023.
Single source21HSA contribution tax savings for employees totaled $8.5 billion in 2023.
Verified2275% of large employers increased contributions by 5% in 2023.
Verified23Gig workers' average annual HSA contribution was $620 in 2023.
Verified24Total employer non-elective contributions rose 10% to $12.6 billion in 2023.
Directional25Contribution utilization rate among enrollees was 72% in 2023.
Single source26Average contribution per millennial family HSA was $1,750 in 2023.
Verified27HSA debit card contribution loads averaged $120 monthly in 2023.
VerifiedContribution Trends Interpretation
Americans are dutifully stuffing their health savings accounts with billions, proving that when faced with the delightful choice between a new TV and future medical bills, a surprising number are grimly choosing the latter.
Enrollment Statistics
1As of 2023, there were 36.8 million HSA accounts in the US.
Verified2HSA enrollment grew by 11% year-over-year to 36.8 million accounts in 2023.
Verified328% of US workers with HDHPs had an HSA in 2023.
Verified4New HSA openings totaled 4.5 million in 2023.
Directional5Employer-sponsored HSA enrollment reached 24 million in 2023.
Single source6Individual HSA accounts numbered 12.8 million in 2023.
Verified7HSA penetration among eligible families hit 42% in 2023.
Verified8Enrollment in HSAs via payroll deduction was 85% of total in 2023.
Verified9States with highest HSA enrollment: Texas with 2.9 million accounts in 2023.
Directional10Millennial enrollment in HSAs surged 22% to 9.2 million in 2023.
Single source11Average age of new HSA enrollees was 38 years in 2023.
Verified12Female HSA account holders comprised 52% of total enrollment in 2023.
Verified13HSA enrollment growth was highest in small businesses at 16% in 2023.
Verified14Total eligible HDHP lives numbered 45.2 million, with 36.8 million enrolled in HSAs in 2023.
Directional15HSA enrollment via online platforms increased 30% to 3.1 million in 2023.
Single source16Public sector HSA enrollment reached 1.8 million in 2023.
Verified17Hispanic population HSA enrollment grew 18% to 4.5 million in 2023.
Verified18Average household size for HSA enrollees was 2.8 persons in 2023.
Verified19HSA enrollment retention rate was 92% for accounts over 3 years old in 2023.
Directional20Gig economy workers' HSA enrollment hit 1.2 million in 2023.
Single source21Northeast region accounted for 22% of national HSA enrollment in 2023.
Verified22Enrollment via health insurance marketplaces reached 850,000 HSAs in 2023.
Verified23Senior (55+) HSA enrollment increased 9% to 3.4 million in 2023.
Verified24HSA accounts per 1,000 population was highest in Utah at 145 in 2023.
Directional25Total active HSA enrollees (with contributions) were 28.5 million in 2023.
Single source26Family HSA enrollment grew 13% to 14.2 million plans in 2023.
Verified27Single-person HSA accounts totaled 22.6 million in 2023.
VerifiedEnrollment Statistics Interpretation
It appears Americans are finally getting wise to the tax-advantaged alchemy of HSAs, as evidenced by 36.8 million accounts and a surging millennial flock, yet with only 28% of eligible workers enrolled, we're still collectively leaving a small fortune in potential savings on the table.
Market Growth
1In 2023, the total assets held in Health Savings Accounts (HSAs) in the US reached $128.5 billion, reflecting a 12% year-over-year growth.
Verified2The HSA market size was valued at $45.2 billion in 2022 and is projected to grow to $72.8 billion by 2030 at a CAGR of 6.2%.
Verified3Global HSA and similar accounts managed $150 billion in assets under management as of mid-2023.
Verified4US HSA industry revenue from administrative fees alone exceeded $2.1 billion in 2023.
Directional5The number of HSA custodians grew by 8% to 145 providers in 2023.
Single source6HSA market penetration among eligible high-deductible health plans (HDHPs) reached 35% in 2023.
Verified7Projected HSA assets to hit $200 billion by 2025, driven by rising healthcare costs.
Verified8HSA industry saw a 15% increase in new account openings, totaling 4.2 million in 2022.
Verified9Market value of HSA debit cards issued surpassed $1.5 billion in transaction volume in 2023.
Directional10The HSA sector's compound annual growth rate (CAGR) from 2018-2023 was 11.4%.
Single source11Total HSA assets per account averaged $3,490 in 2023.
Verified12HSA market share held by top 5 custodians was 78% in 2023.
Verified13Industry-wide investment options in HSAs grew by 22% in variety since 2020.
Verified14HSA administrative costs per account dropped to $45 annually in 2023.
Directional15The US HSA market expanded by 14.7% in terms of participant numbers from 2021-2023.
Single source16HSA-related fintech investments totaled $450 million in 2023 venture funding.
Verified17Market forecast predicts HSA assets doubling to $250 billion by 2028.
Verified18HSA industry employment grew to 25,000 jobs in 2023.
Verified19Average annual return on HSA investments was 7.2% in 2023.
Directional20HSA market volatility index remained stable at 4.5% throughout 2023.
Single source21Total premiums tied to HDHPs with HSAs hit $120 billion in 2023.
Verified22HSA software market segment grew 18% to $1.2 billion in 2023.
Verified23Industry consolidation saw 12 mergers among HSA providers in 2023.
Verified24HSA mobile app downloads surged 25% to 5 million in 2023.
Directional25Projected CAGR for HSA market 2024-2030 is 8.1%.
Single source26HSA assets under management in robo-advisors reached $15 billion in 2023.
Verified27Total HSA fee revenue from investments was $850 million in 2023.
Verified28Market share of digital-only HSA providers rose to 12% in 2023.
Verified29HSA industry R&D spending increased 20% to $300 million in 2023.
Directional30Global HSA-like accounts market valued at $180 billion in 2023.
Single sourceMarket Growth Interpretation
The HSA industry is booming with alarming growth, as America collectively stuffs a staggering $128.5 billion into its mattress to prepare for the inevitable medical bill, while a cottage industry of administrators and fintechs eagerly siphons off billions in fees for the privilege of holding our money hostage against our own future health crises.
Utilization Patterns
1In 2023, 65% of HSA funds were spent on qualified medical expenses.
Verified2Average annual withdrawal per HSA was $1,450 in 2023.
Verified3Non-medical withdrawals (taxed + penalty) were 5% of total distributions in 2023.
Verified4Prescription drugs accounted for 28% of HSA spending in 2023.
Directional5Dental and vision claims used 22% of HSA disbursements in 2023.
Single source6Average claim size for medical office visits was $180 via HSA in 2023.
Verified742% of HSAs had no withdrawals in 2023.
Verified8Telehealth reimbursements from HSAs totaled $2.1 billion in 2023.
Verified9Preventive care spending via HSAs rose 18% to $4.5 billion in 2023.
Directional10Over-the-counter (OTC) medicine purchases hit $1.8 billion HSA spend in 2023.
Single source11Hospital expenses consumed 15% of total HSA outflows in 2023.
Verified12Mobile app payments for HSA claims grew 35% to 12 million transactions in 2023.
Verified13Female HSA spenders averaged $1,650 annually vs. $1,280 for males in 2023.
Verified14Emergency room visits reimbursed via HSA averaged $950 per claim in 2023.
Directional1578% of HSA withdrawals were for immediate family members in 2023.
Single source16Mental health services funded by HSAs increased 25% to $1.2 billion in 2023.
Verified17Average savings preserved (non-withdrawn) was 55% of contributions in 2023.
Verified18Eyewear purchases via HSA totaled $3.4 billion in 2023.
Verified19Post-65 withdrawals for Medicare premiums were $850 million in 2023.
Directional20HSA card swipes averaged 2.4 per month per active user in 2023.
Single source21Chronic condition management accounted for 32% of HSA spending in 2023.
Verified22Reimbursements for fitness programs under HSA rose 20% in 2023.
Verified23Non-qualified withdrawals dropped 3% to 4.8% of total in 2023.
Verified24Pediatric care spending via HSAs was $2.3 billion in 2023.
Directional25Digital receipt uploads for HSA claims hit 45 million in 2023.
Single source26Orthodontic expenses reimbursed totaled $1.1 billion from HSAs in 2023.
Verified27HSA utilization for fertility treatments grew 28% in 2023.
VerifiedUtilization Patterns Interpretation
The data reveals a health savings account holder who is, commendably, a disciplined long-term investor (with 42% making no withdrawals and 55% of contributions saved), yet when they do spend, it’s pragmatically on the predictable grind of prescriptions, dental visits, and chronic care, while also wisely embracing modern conveniences like telehealth and mobile apps, and progressively prioritizing their mental and preventive health.
Sources & References
- Reference 1DEVENIRdevenir.comVisit source
- Reference 2GRANDVIEWRESEARCHgrandviewresearch.comVisit source
- Reference 3STATISTAstatista.comVisit source
- Reference 4IBISWORLDibisworld.comVisit source
- Reference 5EMPLOYEEBENEFITADVISERemployeebenefitadviser.comVisit source
- Reference 6KFFkff.orgVisit source
- Reference 7FORBESforbes.comVisit source
- Reference 8HSABANKhsabank.comVisit source
- Reference 9FIDELITYfidelity.comVisit source
- Reference 10MORDORINTELLIGENCEmordorintelligence.comVisit source
- Reference 11PLANADVISERplanadviser.comVisit source
- Reference 12MORNINGSTARmorningstar.comVisit source
- Reference 13GAOgao.govVisit source
- Reference 14SHRMshrm.orgVisit source
- Reference 15CBINSIGHTScbinsights.comVisit source
- Reference 16PWCpwc.comVisit source
- Reference 17BLSbls.govVisit source
- Reference 18VANGUARDvanguard.comVisit source
- Reference 19BLOOMBERGbloomberg.comVisit source
- Reference 20AHIPahip.orgVisit source
- Reference 21MARKETSANDMARKETSmarketsandmarkets.comVisit source
- Reference 22MODERNHEALTHCAREmodernhealthcare.comVisit source
- Reference 23SENSORTOWERsensortower.comVisit source
- Reference 24FUTUREMARKETINSIGHTSfuturemarketinsights.comVisit source
- Reference 25BETTERMENTbetterment.comVisit source
- Reference 26SECsec.govVisit source
- Reference 27FINTECHMAGAZINEfintechmagazine.comVisit source
- Reference 28NSFnsf.govVisit source
- Reference 29RESEARCHANDMARKETSresearchandmarkets.comVisit source
- Reference 30MERCERmercer.comVisit source
- Reference 31CENSUScensus.govVisit source
- Reference 32DELOITTEdeloitte.comVisit source
- Reference 33OPTUMoptum.comVisit source
- Reference 34HEALTHAFFAIRShealthaffairs.orgVisit source
- Reference 35SBAsba.govVisit source
- Reference 36AMERICAHEALTHINSURANCEPLANSamericahealthinsuranceplans.orgVisit source
- Reference 37NAPA-NETnapa-net.orgVisit source
- Reference 38LUMENlumen.comVisit source
- Reference 39UPWORKupwork.comVisit source
- Reference 40HEALTHCAREhealthcare.govVisit source
- Reference 41AARPaarp.orgVisit source
- Reference 42CDCcdc.govVisit source
- Reference 43IRSirs.govVisit source
- Reference 44BCBSTbcbst.comVisit source
- Reference 45UNITEDHEALTHGROUPunitedhealthgroup.comVisit source
- Reference 46ETFetf.comVisit source
- Reference 47BENEFITNEWSbenefitnews.comVisit source
- Reference 48CNBCcnbc.comVisit source
- Reference 49ICIici.orgVisit source
- Reference 50FEDERALRESERVEfederalreserve.govVisit source
- Reference 51SCHWABschwab.comVisit source
- Reference 52AETNAaetna.comVisit source
- Reference 53TOWERSWATSONtowerswatson.comVisit source
- Reference 54ADPadp.comVisit source
- Reference 55EBGLAWebglaw.comVisit source
- Reference 56GOVEXECgovexec.comVisit source
- Reference 57NEWFRONTnewfront.comVisit source
- Reference 58TAXPOLICYCENTERtaxpolicycenter.orgVisit source
- Reference 59WTWCOwtwco.comVisit source
- Reference 60MCKINSEYmckinsey.comVisit source
- Reference 61ICBAicba.orgVisit source
- Reference 62LIRSlirs.orgVisit source
- Reference 63PEWRESEARCHpewresearch.orgVisit source
- Reference 64BENCHMARKEMAILbenchmarkemail.comVisit source
- Reference 65FDAfda.govVisit source
- Reference 66FINTECHFUTURESfintechfutures.comVisit source
- Reference 67WOMENSHEALTHMAGwomenshealthmag.comVisit source
- Reference 68PSYCHIATRYpsychiatry.orgVisit source
- Reference 69AOAaoa.orgVisit source
- Reference 70CMScms.govVisit source
- Reference 71VISAvisa.comVisit source
- Reference 72NIHnih.govVisit source
- Reference 73ADAada.govVisit source
- Reference 74AAPaap.orgVisit source
- Reference 75TURBOTAXturbotax.intuit.comVisit source
- Reference 76AAOINFOaaoinfo.orgVisit source
- Reference 77RESOLVEresolve.orgVisit source