HSA Statistics (2026)

Health savings accounts have grown into a major pool of tax-advantaged savings. At year-end 2025, Americans held about 41.7 million HSAs containing nearly $174 billion in assets, according to Devenir, the industry's benchmark market survey (see the table below).

Both sides grew: accounts rose about 6% over the year and assets jumped 19%, 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 but at a slowing pace. Devenir counted about 35.5 million HSAs at the end of 2022, roughly 37 million in 2023, over 39 million in 2024, and 41.7 million at year-end 2025 (see the chart below).

Annual account growth has cooled to the mid-single digits, around 5-6%, as HDHP enrollment matures. Not every account is active: at midyear 2025 about 19% of all HSAs were unfunded, a share that is much higher among accounts not tied to an employer.

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 just $104 billion at the end of 2022.

That is a 19% one-year gain and roughly a two-thirds increase over three years. Rising balances, steady net contributions, and market gains on the invested share all fed the total, which Devenir projects will surpass $234 billion by the end of 2028.

Dividing total assets by accounts gives an average balance of about $4,170 at year-end 2025, but that single number is misleading. Balances are heavily skewed: a small group of long-held, invested accounts holds most of the money while a large tail sits near zero.

EBRI's account-level database, a large sample rather than the whole market, put the average balance at $4,747 in 2023, up from $4,607 in 2022. 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, and nearly $174 billion in 2025 (see the chart and table below).

Assets have grown roughly 19% 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 $85 billion at year-end 2025, up 33% in a year, and now make up roughly 49% of all HSA dollars (see the table below).

That is up from $64 billion at the end of 2024 and about $73 billion at midyear 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 4.2 million HSAs held investments at year-end 2025, roughly 10% of all accounts, up 22% year over year (see the chart above).

EBRI, using a different sample, found only about 15% of accountholders invested in anything other than cash. The gap matters: invested accounts averaged over $24,000 at year-end 2025, many times the balance of cash-only accounts, 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).

That mirrors 2024, when contributions were almost $56 billion against $42 billion of withdrawals. In the first half of 2025 alone, $33.0 billion went in and $22.7 billion came out, so contributions outran withdrawals by roughly 1.4 to 1.

Most people contribute far below the cap. In EBRI's database (2022, the latest detailed contribution year), the average individual contribution was $1,962 and the average employer contribution $762, for a combined figure that fell about $926 short of the self-only maximum and $4,576 short of the family maximum.

Employer contributions matter a lot: accounts that receive them tend to carry higher balances and are more likely to be invested. Only a small minority of accountholders contribute the full statutory limit in any given year.

HSAs are still used mostly to pay medical bills, not just to save. More than half of the accounts in EBRI's database took a distribution in 2023, and the average distribution was about $1,801 (EBRI, a partial sample).

Devenir's data shows most withdrawals happen by debit card, about 91% of transactions at an average of roughly $123 each in early 2025. 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 accounts opened back in 2004 averaged about $33,010 at midyear 2025, while accounts opened in the first half of 2025 averaged just $1,723. Time, contributions, and investing compound together.

Most HSAs run through the workplace. About 61% of accounts were employer-affiliated at year-end 2025, and those accounts held roughly 65% of all HSA assets, reflecting payroll contributions and employer seed money.

The distinction shows up in funding. Only about 13% of employer-affiliated accounts were unfunded at year-end 2025, versus roughly 36% of accounts opened outside an employer, where people often set up an HSA but never contribute.

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, 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. 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 over $24,000 versus a market average near $4,170, the difference between using an HSA as a checking account and using it as a long-term investment account is enormous.