Explaining Health Savings Accounts in the Affordable Care Act Marketplaces

This brief examines how the budget reconciliation law expanded access to HSA-eligible plans and accounts on the ACA Marketplaces and what these changes means for enrollees. Health Savings Accounts (HSAs) are tax-advantaged savings accounts that enrollees in certain high-deductible health plan (HDHPs) can use to pay for qualified medical expenses.

HSA-compatible plan options have grown substantially since the law took effect, creating both benefits and risks for consumers. For example, Marketplace enrollees could benefit from the tax advantages of contributing to an HSA—but doing so requires enrolling in a high-deductible plan and anticipating future health care costs and income.

The brief is part of the Peterson-KFF Health System Tracker, an online information hub dedicated to monitoring and assessing the performance of the U.S. health system.