As Americans continue to contend with rising prices on everyday goods and services and major purchases, they need a diversity of strategies to save money and build an economic safety net.

Health Savings Accounts are an increasingly popular option for healthcare savings for the 53% of Americans working in the private sector who are covered by a High Deductible Health Plan (HDHP). When paired with an HDHP, HSAs offer tax-advantaged saving, investing, and spending on qualified healthcare expenses. HSAs belong to the account holder, and roll over year-to-year, and can also be used to boost retirement savings. The amount of assets held in HSAs increased by 19% in 2023 to $123 billion in over 37 million accounts and the number of accounts increased by 5% according to Devenir’s annual report.

While growth of Health Savings Accounts overall has slowed over the past few years, Health Savings Accounts are now a mainstream component of Americans day-to-day budgeting and savings practices. HSA Snapshot, Lively’s sixth annual HSA spend report, explores how Lively’s account holders spent, saved, and invested their healthcare dollars in 2023, and what these habits can show us about national healthcare trends.

The report examines:

• How HSA account holders spend, especially on routine expenses, prescription drugs, and major healthcare emergencies such as hospital visits.
• HSA consumer spending habits, including year-over-year changes since 2019.
• How Lively account holders saved, spent, and invested their HSA dollars compared to industry averages.
• What benefits brokers, consultants, and HR and benefits professionals can do now in order to take advantage of HSAs and offer their employees flexible, inclusive, competitive benefits in 2025.

Overall, this year’s report found that after some exceptional fluctuations in saving habits during the height of the COVID-19 pandemic in 2020 and 2021, how account holders use their HSAs has mostly stabilized. Spending levels are close to what they were pre-pandemic, but HSAs usage also reflects higher post-pandemic prices, especially for prescription drugs. It also includes critical actions employers and brokers can take as they look ahead to 2025.