HSA Statistics (2026)

Health savings accounts have grown into a major pool of tax-advantaged savings. At midyear 2026 (June 30), Americans held about 42.6 million HSAs containing nearly $192 billion in assets, according to Devenir, the industry's benchmark market survey (see the table below).

Both sides grew: accounts rose about 7% over the year, a modest pickup from the 5-6% pace of recent years, and assets jumped 20%, helped by strong contributions and a rising stock market. HSAs pair with high-deductible health plans and carry a rare triple tax advantage, which keeps drawing new money in.

The number of open accounts has climbed steadily. Devenir counted about 35.5 million HSAs at the end of 2022, roughly 37 million in 2023, over 39 million in 2024, 41.7 million at year-end 2025, and 42.6 million at midyear 2026, after nearly 3.0 million openings and 2.1 million closures in the first half of the year (see the chart below).

Not every account is active: at midyear 2026 about 20% of all HSAs had a zero or negative balance, down from 22% at year-end 2025 but slightly above the 19% a year earlier. The share is much higher among accounts not tied to an employer. Starting in 2026, bronze and catastrophic marketplace plans count as HSA-compatible, which Devenir expects to lift account openings first.

Assets have grown faster than accounts because balances compound. Total HSA assets reached nearly $174 billion at year-end 2025, up from $147 billion a year earlier and $104 billion at the end of 2022, and climbed to nearly $192 billion by midyear 2026.

That is a 20% one-year gain. Rising balances, steady net contributions, and market gains on the invested share all fed the total, which Devenir projects will reach $246 billion by the end of 2028.

Devenir put the average balance at $4,504 at midyear 2026 counting every account, and $5,642 among funded accounts, up 14% in a year. That single number is still misleading: about half of all accounts (51%) hold under $500, while 10.4% hold $10,000 or more and hold a large share of the money.

EBRI's account-level database, a large sample rather than the whole market, put the average balance at $5,532 at the end of 2024, the highest in its history, up from $4,747 in 2023. Median balances are far lower than averages because so many accounts hold only a few hundred dollars.

The long arc is steep. HSA assets were about $82 billion at the end of 2020, crossed $100 billion in 2022, hit $123 billion in 2023, $147 billion in 2024, nearly $174 billion in 2025 and nearly $192 billion at midyear 2026 (see the chart and table below).

Assets have grown roughly 19-20% a year in each of the last three years. Accounts have grown more slowly, so the average balance keeps rising as existing accounts accumulate contributions and investment gains year after year.

The biggest shift in the HSA market is money moving from cash into investments. HSA investment assets reached about $100 billion at midyear 2026, up 37% in a year, and for the first time make up the majority of HSA dollars, 52%, up from 46% a year earlier (see the table below).

That is up from $64 billion at the end of 2024, about $73 billion at midyear 2025 and $85 billion at year-end 2025. As balances grow past the deductible people need on hand, more of the money gets invested for the long term rather than left as spending cash.

Despite the surge in invested dollars, most accountholders still do not invest. About 4.7 million HSAs held investments at midyear 2026, roughly 11% of all accounts, yet those accounts hold 59% of all HSA assets.

EBRI, using a different sample, found 18% of accountholders invested in anything other than cash in 2024, the eighth straight yearly increase. The gap matters: invested accounts averaged $23,837 in combined deposits and investments at midyear 2026, about nine times the average funded cash-only account, because they benefit from both larger contributions and market growth.

Money keeps flowing in faster than it flows out. Account holders contributed nearly $60 billion to HSAs in 2025 and withdrew nearly $45 billion, retaining about $15 billion for the year (see the table below).

In the first half of 2026, $35.2 billion went in (up 7% from a year earlier) and $23.8 billion came out (up 5%), leaving $11.5 billion, or 32% of contributions, retained. Newer accounts are the strongest savers: accounts opened in 2026 put in $4.10 for every dollar withdrawn, versus $1.40 for 2024 accounts.

Most people contribute below the cap. In EBRI's database for 2024, among accountholders who contributed, the average employee contribution was $2,308 and the average employer contribution $727; the average combined contribution fell $505 short of the self-only maximum and $4,755 short of the family maximum.

Employer contributions matter a lot: accounts that receive them tend to carry higher total contributions and are more likely to be invested. In Devenir's first-half 2026 data, employers supplied 25% of all HSA dollars contributed and employees 60%, with an average employer contribution of $676 and employee contribution of $1,458 among those contributing.

HSAs are still used mostly to pay medical bills, not just to save. In EBRI's database, 56% of accounts took a distribution in 2024 and the average distribution was $1,870, even as out-of-pocket health spending rose 5.9% (EBRI, a partial sample).

Devenir's data shows most withdrawals happen by debit card, about 91% of transactions at an average of roughly $125 each in the first half of 2026, and 78% of withdrawal dollars. The pattern is many small health-spending withdrawals rather than large lump sums.

Balances rise sharply with age and with how long an account has been open. EBRI's 2023 data shows an average of $1,154 for accountholders under 25 versus $9,022 for those 65 and older (see the chart and table below).

Tenure matters even more: Devenir found funded accounts opened back in 2004 averaged $36,870 at midyear 2026, while accounts opened in 2026 averaged just $1,963. Time, contributions, and investing compound together.

Most HSAs run through the workplace. About 26 million accounts, 61% of the total, were employer-affiliated at midyear 2026, and those accounts held about $125 billion, roughly 65% of all HSA assets, which reflects payroll contributions and employer seed money.

The distinction shows up in funding. Only about 12% of employer-affiliated accounts were unfunded at midyear 2026, versus roughly 33% of accounts opened outside an employer. Among funded accounts, though, non-employer HSAs held the higher average balance, $5,937 versus $5,496.

The IRS sets HSA limits each year, and you must be covered by a qualifying high-deductible health plan to contribute. For 2026 the contribution limit is $4,400 for self-only coverage and $8,750 for family coverage, rising to $4,500 and $9,000 in 2027, with an extra $1,000 catch-up at age 55 and older (see the table below).

To be HSA-eligible in 2026, an HDHP must have a deductible of at least $1,700 self-only or $3,400 family, and out-of-pocket costs capped at $8,500 or $17,000; for 2027 those become $1,750, $3,500, $8,700 and $17,400. In 2024, about 27% of covered workers were in an HSA-qualified or savings-option HDHP, per KFF.

The HSA is often called the most tax-advantaged account available: contributions are pre-tax, growth is tax-free, and withdrawals for qualified medical expenses are tax-free too. Yet the data shows most people leave that third benefit on the table by holding cash and spending as they go.

The accounts that build real wealth are the ones that get funded consistently, invested once a cash buffer is set aside, and left to compound. With invested accounts averaging $23,837 versus a funded-account average of $5,642, the difference between using an HSA as a checking account and using it as a long-term investment account is enormous.