An older couple with an advisor
Enrollment in High-Deductible Health Plans (HDHP) is on the rise. The AARP (American Association of Retired Person) says that over the past decade and a half, employers have come to rely on HDHPs as a common coverage option.
The KFF Annual Benefits Survey shows that between 2011 and 2024, around one-quarter of employers offered an HDHP to employees. The Association’s analysis showed that between 2012 and 2022, the share of older workers enrolled in an HDHP increased from 30% to 53%, which is a 77% increase. By 2022, 16.4 million older workers were enrolled in an HDHP. Across each income category, older worker enrollment in HDHPs grew comparably, around 20 percentage points, between 2012 and 2022.
Although there are employer-offered HDHPs that are not HSA qualified, HSA-qualified HDHPs make up nearly 90% of all HDHPs offered by employers in 2024. Enrollment in HDHPs with an HSA among older workers is low but growing. Less than half of older workers are enrolling in both HDHPs and HSAs, despite the widespread offers of HSA-eligible HDHPs to employees. Among midlife adults with an HDHP in 2022, 49% had an HAS. However, enrollment in an HDHP with an HSA grew 13 percentage points between 2012 (36%) and 2022.
Additionally, rates of older workers enrolled in both HDHPs and HSAs vary by what they earn. Higher-income older workers enrolled in HDHPs are much more likely to also have an HSA than lower-income workers. In 2012, only 14% of low-income older workers (household income less than 200% of the federal poverty level) had both an HDHP and an HSA, compared to 41% of high-income workers (household income greater than 400% of the federal poverty level).
In 2022, the enrollment gap between these income groups remained relatively large, with 30% of low-income older workers enrolled in both an HDHP and an HSA, compared to 52% of high-income workers. This gap is consistent with research showing that higher-income adults of all ages are more likely to have HSAs than lower-income adults.
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