Health Savings Accounts (HSA) have been promoted by financial analysts as a great way to help cover doctor visits, dentist cleanings, eye exams, prescriptions, and copays.
But a new report from the Employee Benefit Research Institute (EBRI) finds some mixed signals on those who have these accounts.
EBRI says that average health savings account (HSA) balances reached a record $5,532 in 2024, even as 56% of accountholders took distributions and only 18% invested HSA funds in assets other than cash.
The report, “Trends in Health Savings Account Balances, Contributions, Distributions, and Investments, 2011–2024,” examines more than a decade of HSA activity, including account balances, individual and employer contributions, distributions, and investment behavior.
The EBRI HSA Database contained 15.2 million accounts with $53.7 billion in total assets as of Dec. 31, 2024.
Key findings in the report include:
While average balances have increased, average HSA balances remain relatively low. Average year-end HSA balances reached $5,532 in 2024, the highest level recorded in EBRI’s HSA Database and up from $4,747 in 2023.
However, average balances remained modest compared with out-of-pocket maximums for HSA-eligible health plans, which were $8,050 for individual coverage and $16,100 for family coverage in 2024. More than 40% of the HSAs in EBRI’s database were opened since 2022.
Few account holders contribute the maximum. Among accountholders who made a contribution, the average employee contribution increased to $2,308 in 2024, while the average employer contribution decreased slightly to $727. After adjusting for inflation, both employer and employee contributions were higher in the 2010s.
Most accountholders take a withdrawal. In 2024, 56% of HSA accountholders took a distribution from their accounts. The average distribution increased slightly to $1,870. Although the average nominal distribution was modestly higher than in 2023, inflation-adjusted distributions were higher in earlier years, particularly during the 2010s.
While the share is rising, fewer than one in five accountholders invest. Only 18% of accountholders invested HSA funds in assets other than cash in 2024. However, the percentage of HSA accountholders who invest has increased for eight consecutive years, an encouraging sign that accountholders are increasingly taking advantage of the investment opportunities and tax benefits HSAs offer.
