HSA participation hits record high, but retirement strategy lags, PSCA finds

Employee participation in workplace health savings accounts jumped sharply in 2025, according to new survey data, even as most employers still haven't positioned the accounts as part of a long-term retirement strategy.

The Plan Sponsor Council of America's 2026 Health Savings Account Survey, sponsored by HSA Bank, found that 83% of employees with access to an HSA contributed to the account in 2025, up from 73.4% in 2024. Average contributions climbed to $2,829 for the year, and account balances ended 2025 at an average of $6,477.

PSCA found that only about one-quarter of employers actively position HSAs as part of a broader retirement savings strategy for employees – a gap the survey's authors describe as an area of opportunity rather than a setted problem.

"Health Savings Accounts are evolving from a healthcare spending vehicle into an important financial wellness and long-term retirement strategy," said Hattie Greenan, PSCA's director of research and communications.

HSA dollars mostly on the sidelines

The survey found 22% of participants invested a portion of their HSA balance in 2025, up from 20.3% in 2024 and 18.9% in 2023. More than two-thirds of employers, 68.5%, now offer HSA investment options, an increase of roughly 13 percentage points since 2022.

Separate data from Devenir earlier this year found HSA investment assets grew 33% in 2025 to roughly $85 billion, though invested accounts still make up only about 10% of all HSAs industrywide. Not so surprisingly, Devenir's year-end figures showed accounts with investments carrying an average combined balance nearly 10 times higher than funded accounts holding cash alone.

Most HSA dollars still remain uninvested. Research from the Employee Benefit Research Institute this month found that just 18% of accountholders had invested any portion of their balance in equities, funds or other non-cash assets in 2024. EBRI put the average HSA balance that year at $5,532 – covering only about two-thirds of the individual out-of-pocket maximum under a high-deductible health plan in 2024.

Read more: Health savings account contributions, investments can be boosted by one key thing

Employer education remains an issue

PSCA's survey reveals education is the biggest barrier to broader use of HSAs in the workplace. Nearly two-thirds of employers, 65.5%, cited employee education as their most common HSA-related concern, while half of employers said they provide HSA education only during open enrollment.

"Employers are expanding support through contributions, automatic enrollment, investment options, and decision-support tools," Greenan said. "Our findings suggest many plan sponsors have an opportunity to help employees better understand the unique role HSAs can play in preparing for healthcare expenses in retirement."

Ann Brisk, senior managing director of innovation and strategy at HSA Bank, suggested workers may be taking a myopic view of HSAs.

"Employees are increasingly contributing to HSAs, but many view them as spending accounts for near-term expenses rather than as tools that can help prepare for retirement," Brisk said. "Employers have an opportunity to provide real-time guidance to help workers understand the value of HSAs, encouraging better informed health and wealth decisions."

Read more: HSAs, an adviser favorite, just don't get much love

The push toward HSAs as longer-term savings vehicles comes as rising health costs are already affecting other parts of workers' finances. A recent LIMRA study found more than three-quarters of workers reported rising medical insurance premiums this year, and that roughly 12% responded by cutting their retirement plan contributions.

PSCA's data also reflect growing momentum behind automatic enrollment: nearly 46% of organizations surveyed now automatically enroll eligible employees in an HSA, up from 43.1% in 2024 and 35.1% five years earlier. More than three-quarters of employers, 77.2%, contribute directly to employee accounts, and 35% now tie rewards to health and wellness program participation, up from 32% the year before.