HSA assets climb to $174B as employee confusion persists

• Key Insight: Discover how rising HSA investments are shifting accounts from spending to long-term savings.
• What's at Stake: Plan design and employer risk depend on HSA adoption, investment, and participant awareness.
• Supporting Data: Nearly $174 billion across 41.7 million HSA accounts at year-end 2025.
  Source: Bullets generated by AI with editorial review

Health savings account assets are expected to grow 12% this year as medical costs rise and more employees invest their contributions. 

HSAs held nearly $174 billion across 41.7 million accounts at the end of 2025, according to Devenir's HSA Market Survey report released last month, a 19% increase from the previous year. 

The investment and research firm projects that the HSA market will surpass 49 million accounts and $234 billion in assets by the end of 2028. 

"If you look at industry data, the biggest jumps in assets are tied to people who are investing," said Kevin Robertson, chief growth officer at HSA Bank. "This was a natural progression of the industry. It just takes time for people to feel familiar and comfortable enough that they are going to be able to afford their current expenses before they invest." 

HSA investment assets climbed to nearly $85 billion by the end of 2025, up 33% from a year earlier, according to Devenir. About 4.2 million accounts — or roughly 10% of all HSAs — held invested dollars, a year-over-year increase of 22%.

"I don't see that trend changing," Robertson said. "In fact, I see it accelerating." 

The number of high-balance accounts has also risen, with accounts holding at least $10,000 increasing nearly sevenfold over the past decade, from about 599,000 at the end of 2015 to 4.1 million at the end of 2025.

Over the same period, accounts with $25,000 or more grew from 114,000 to 1.7 million, a 15-fold increase. In 2025 alone, that tier added nearly 571,000 accounts. 

Meanwhile, the mid-balance segment ($500–$9,999) declined from 42% to 38% of all accounts during the past decade, while the low-balance segment (under $500, including zero-balance accounts) has remained relatively stable, ranging from 51% to 55%.

Don't expect immediate expertise

One of the biggest sources of confusion with HSAs is the "use it or lose it" rule, Robertson said. Unlike flexible spending accounts, which generally require employees to spend most of the money within the plan year, HSAs are individually owned and unused funds roll over indefinitely from year to year. 

Benefit leaders sometimes introduce HSAs and FSAs at the same time, and employees don't always get a clear explanation of the differences. That's why having an effective communication strategy is so important, Robertson said. 

"Don't make assumptions about your employees' familiarity with their healthcare accounts," he said. "Even if it seems redundant to speak to people over and over again, sometimes that repetition is what's necessary to break through."

When talking about HSAs with employees, Robertson recommends that benefit leaders break down the training into what he calls "consumable pieces." 

"Don't try and get a person to be an expert on every single thing you know," he said. "If they're new to an HSA, don't expect them to be an expert tomorrow." 

According to Devenir's report, 6 million new HSA accounts were opened in 2025, and around 3.6 million were closed. Many accounts are opened during fall enrollment but are not funded until the following year. As of the end of 2025, 22% of all accounts held a zero or negative balance, up from 21% a year earlier.

Robertson also noted that HSAs are now more widely usable in the Affordable Care Act marketplace due to legislative changes. The One Big Beautiful Bill Act passed last year expanded eligibility for HSAs to include Bronze and Catastrophic Affordable Care Act plans.

But because the bill was signed into law in July, there wasn't enough time for ACA exchanges and intermediaries to effectively communicate it during the next open enrollment period, Robertson said. As a result, many people went through enrollment without realizing they were newly eligible.

"Right now the challenge is awareness, awareness, awareness," he said.