HSA participation rises, retirement investing lags

Health savings accounts have become a contribution habit: 83% of employees with an HSA put money in during 2025, up from 73.4% a year earlier, and average balances reached $6,477, according to PSCA's 2026 Health Savings Account Survey, sponsored by HSA Bank and reported by NAPA Net. The behavior that turns an HSA into retirement money remains rare—only one-quarter of employers position the account as part of a long-term retirement savings strategy, and just 22% of participants invest any of their HSA savings, a share that has crept up from 20.3% in 2024 and 18.9% in 2023.

The participation gains trace to employers automating the easy part: nearly 46% of organizations now auto-enroll employees in an HSA when they choose an HSA-qualified health plan, up from 43.1% in 2024 and 35.1% five years ago; 77.2% contribute to employee HSAs; and 68.5% offer investment options, a 12.8% increase from 2022. Yet 65.5% of employers cite employee education as their most common HSA concern, and half deliver that education only during open enrollment.

PSCA's Hattie Greenan puts it plainly: "Health Savings Accounts are evolving from a healthcare spending vehicle into an important financial wellness and long-term retirement strategy." HSA Bank's Ann Brisk adds that many employees "view them as spending accounts for near-term expenses rather than as tools that can help prepare for retirement," and the gap shows in the contribution flow: average participant contributions reached $2,829 in 2025.

Employers have built the plumbing—automatic enrollment, employer contributions, investment menus—but stopped before the wiring: only one in five participants invests, and only one in four employers talks about retirement. That mismatch is precisely the opening for an advisor's retirement-income conversation. The HSA should be positioned as a long-term asset with a healthcare drawdown schedule, not a reimbursement wallet for current copays.

The real barrier is the way employers frame the account: they automated enrollment and left education to a single open-enrollment pitch, which suggests they are solving plan participation rather than participant outcomes. For an advisor, that gap is an invitation—the client who treats the HSA as a spending account will carry a low-balance liability into retirement, while the client who treats it as a source of future healthcare income has a measurable advantage.

The practical move is to run the HSA through the same projection used for any retirement asset: contribution rates, investment allocation, and a distribution assumption for Medicare and out-of-pocket healthcare costs. The survey suggests few households are doing that math, and the advisor who brings it to the desk can own the conversation.