Health Savings Account Enrollment Continues to Rise, AHIP Says

By Staff Report

May. 15, 2009

Enrollment in health savings accounts linked to high-deductible health insurance plans continues to surge, with 8 million people covered by HSAs as of January 1, a 31 percent increase in the past year, according to an annual census released Wednesday, May 13, by an industry group.

HSA enrollment rose in all markets, according to Washington-based America’s Health Insurance Plans, and posted the greatest percentage increase in the large-employer market.

Employers with at least 51 employees had 3.8 million people enrolled in HSAs as of January 1, a roughly 35 percent increase in the past year.

Enrollment also increased in other markets. In the small-employer market—or businesses with up to 50 employees—HSA enrollment increased to 2.4 million people, up about 34 percent from a year earlier, while enrollment in the individual market climbed to 1.8 million, an increase of about 22 percent.

HSAs, authorized under a 2003 federal law that added a prescription drug benefit to the Medicare program, became available on January 1, 2004, and enrollment has been surging since then.

For example, AHIP surveys found HSA enrollment of 1 million people in March 2005, 3.2 million as of January 2006, 4.5 million as of January 2007 and 6.1 million as of January 2008.

The key factor driving HSA growth is that premiums for high-deductible health insurance plans—to which HSAs must be linked by law—tend to be much lower than more traditional health plans, where enrollee cost-sharing is lower. In 2009, the minimum deductible of an HSA-linked health insurance plan is $1,150 for single coverage and $2,230 for family coverage.

The census is based on 96 insurers and their subsidiaries offering HSA-linked health insurance plans. AHIP said it believes its annual census covers virtually all people enrolled in plans linked to HSAs.

Copies of the 2009 census are available at

Filed by Jerry Geisel of Business Insurance, a sister publication of Workforce Management. To comment, e-mail

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