HSA balances, contributions grew despite higher health spending

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Despite increased health care spending in 2021, Health Savings Account (HSA) enrollees ended the year with higher balances in their accounts, according to a new study from the Employee Benefit Research Institute (EBRI). The analysis outlines some interesting findings about HSA accounts in the year after the worst of the COVID pandemic. For the report, researchers looked at data from more than 13 million HSA accounts in the U.S.

EBRI officials said the findings were unexpected given the rebound in utilization of health care services in 2021. During the pandemic of 2020, health care spending decreased significantly, as people dropped doctor office visits and preventive care, sometimes because clinics were closed, or because of fears of COVID transmission. Yet when the utilization of care rebounded in 2021, HSA withdrawals to pay for care (called distributions) did not show a matching increase. The study found that out-of-pocket spending increased by more than 10% in 2021, yet the average HSA balance increased the same year, rising from $2,645 at the beginning of the year to $3,902 by the end of the year.