HSA Assets Grew by 19% in 2025

Health savings accounts held nearly $174 billion at the end of 2025, a sharp rise from 2024 that underscores their growing role not only as a tool for paying medical bills, but increasingly as a vehicle for long-term savings for retirement.

The total value of HSA assets climbed 19% over the past year, according to a new Devenir report, while the number of accounts reached 41.7 million, a 6% increase from 2024.

The expansion comes as policymakers move to broaden access to the accounts and as Americans confront persistently high health care costs. Further, the accounts are increasingly being used to save for expenses in retirement.

More account holders are leaving their HSA money untouched, investing balances and accumulating larger sums over time. Investment assets alone rose 33% to about $85 billion last year, now accounting for nearly half of all HSA funds, Denevir reported.

That shift has changed how the accounts, originally conceived as a way to cover out-of-pocket medical expenses tied to high-deductible health plans. Increasingly, they are being viewed as a hybrid savings-and-investment vehicle, aided by their unusual “triple tax advantage”—contributions, investment growth and qualified withdrawals are all tax-free.

That said, many still use the accounts for ongoing health expenses. Surveys show that most Americans continue to use their accounts for immediate health expenses, rather than saving for the future. About two-thirds of account holders reported spending their HSA funds on near-term costs, a recent Employee Benefit Research Institute report found.

A Growing Financial Cushion

The latest data suggest that balances are steadily increasing. Roughly 4.1 million accounts now hold at least $10,000, and 1.7 million accounts exceed $25,000, Devenir reported.

Contributions are also outpacing withdrawals. Americans added nearly $60 billion to their accounts in 2025 while withdrawing about $45 billion, leaving an estimated $15 billion to accumulate.

At the same time, rising health care costs are pushing more people to rely on HSA funds. Four in 10 Americans reported higher health expenses in the past year, with many cutting back on savings or taking on debt to cope, according to EBRI.

Policy Changes Expand Access

Federal policy changes are also helping fuel HSA growth. Recent guidance from the IRS expanded eligibility, allowing more types of insurance plans—including some lower-tier marketplace options—to qualify for starting and maintaining an HSA.

The rules also permit certain telehealth services and direct primary care fees to be covered from an HSA without jeopardizing eligibility, potentially making the accounts more attractive to a broader range of consumers.

Lawmakers are pushing to go even further. Legislation introduced in the Senate earlier this week would expand HSA access to people enrolled in Medicare and Medicaid; allow money in HSAs to be used for insurance premiums; and loosen restrictions on eligible health plans. The “HSAs for All Act,” introduced in the House of Representatives earlier this year, similarly intends to expand HSA access.

Supporters argue that such changes would give Americans more flexibility in managing health costs, while critics have raised concerns about whether the benefits disproportionately favor higher-income households that are more able to save.

Devenir estimated that the HSA market will surpass 49 million accounts and $234 billion in assets by the end of 2028.