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In the runup to the creation of Health Savings Accounts (HSAs), consumer-directed benefits (CDBs) had just started making inroads in American health care. Many consumers and employers were looking forward to HSAs, the latest output from this growing trend. The accounts were anticipated to slow rising health care costs and encourage individuals to be more engaged with their health care choices.

It was in this environment that I founded HealthEquity, which opened its doors 20 years ago in 2002. In the years since, HSAs have become a prominent fixture in the nation’s health care system. According to the latest figures from Devenir Research, Americans now hold more than $100 billion in nearly 34 million accounts. Those savings benefit from the HSA’s unique triple tax advantage: funds are tax-free going into the account, grow tax-free in the HSA, and are not subject to taxation when spent on qualified medical expenses.

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