Health Savings Accounts Continue to Expand

January 21, 2014 ( – A new survey finds that while health savings accounts (HSAs) continued to expand in 2013, health reimbursement arrangements (HRAs) declined for the first time in a decade.

The results of the 2013 Consumer Engagement in Health Care Survey, from the Employee Benefit Research Institute (EBRI) and Greenwald & Associates, may foreshadow a change in how account-based health plans are funded, since HSAs can be funded by employer and employee contributions, while HRAs are solely employer-funded.

In fact, the survey results show that there were 4.7 million HRA accounts in 2013, down from 5.1 million in 2012. On the other hand, HSAs increased from 6.6 million to 7.2 million between 2012 and 2013. Assets in HRAs fell slightly and were about $5.8 billion in 2013, while assets in HSAs increased from $11.3 billion to $16.6 billion between 2012 and 2013.

“Both HSAs and HRAs have been around long enough now that a growing percentage of the population has held them for a number of years. Together, they covered about 26 million people in 2013, representing about 15% of the privately insured market,” says Paul Fronstin, director of the EBRI Health Research and Education Program and author of the report. “But the two types of plans appear to be taking different directions.”

Additionally, survey results indicate that in 2013, the average account balance in an HSA was $2,311, as compared with $1,236 in HRAs. Average HSA balances increased from just above $1,400 in 2008 to $2,311 in 2013. In contrast, average HRA balances increased from $1,130 in 2008 to $1,236 2013.

More information about the survey results can be found in the January EBRI Issue Brief under the title “Health Savings Accounts and Health Reimbursement Arrangements: Assets, Account Balances, and Rollovers, 2006–2013.” This piece can be found on the EBRI website.