At a time of rising costs and growing uncertainty in the health care industry, one thing appears to be certain – health savings accounts continue to be a popular option. In January 2024, 38.8 million people were enrolled in HSA-eligible health plans, an increase from 32.1 million in 2019.
“Consumer-directed health plans combine a high-deductible, lower-premium plan with a tax-advantaged HSA and have been a steadily growing benefit option for millions of Americans since first being offered in 2004,” according to a report issued by AHIP. “HSA plans offer a way to save and invest money tax free for future health care costs while maintaining available funds for current expenses, including cost-sharing.”
Among the key findings of the report:
- HSAs accounted for nearly 18% of total commercial health plan enrollment in 2024, including group health plans and individual health insurance. This represents an increase from 15% of total commercial enrollment in 2019.
- Large-group coverage accounted for the majority of HSA-eligible health plan enrollment. Generally, large-group coverage was defined as policies offered by employers with 50 or more employees.
- As of January 2024, 90% of HSA-eligible health plan enrollees were in the large group market, followed by 7% in the small-group market. Individual market coverage accounted for only 3% of HSA-eligible health plan enrollment.
- By plan type, PPO plans accounted for more than three-quarters of HSA-eligible health plan enrollment. Similarly, 75% of HSA-eligible health plan enrollees were enrolled in the self-insured plans. Seventy-seven percent of HSA-eligible health plan enrollees in the individual market were enrolled through the exchanges, of which 56% were eligible for advance premium tax credits.
Compared to all commercial plans, consumers enrolled in HSA-eligible health plans tended to be slightly older. Children 18 and younger accounted for 21% of the HSA-eligible health plan enrollment, compared to a quarter of all commercial enrollees. In contrast, 36% of HSA-eligible health plan enrollees were 25 to 44 years old, compared to only 32% of all commercial enrollees. Men were slightly more likely than women to be enrolled in HSA-eligible health plans (51% vs. 49%), compared to evenly split enrollment for all commercial health plans.
Many health insurers offering HSA-eligible plans have created tools to help members manage their accounts online. Such accounts allow members to access information about their health conditions, medical services and health care costs. Telehealth offers a convenient and cost-effective way for patients to see their doctor without having to leave their home or workplace, and nearly all HSA-eligible health plans cover telehealth services on a pre-deductible basis.