HSA, HRA Account Balances Grew in 2011, 2012

After a slight drop during the economic downturn, health savings accounts (HSAs) and health reimbursement arrangements (HRAs) are showing renewed growth, the average account balance increasing over the past two years, according to new research from the Employee Benefit Research Institute (EBRI).

These individual health accounts are a central element in so-called “consumer-driven” health plans, which first began to appear in the workplace about 12 years ago. They are designed to give individuals more control over funds allocated for healthcare services, thereby causing health plan participants to spend the money more responsibly.

Results from the 2012 Consumer Engagement in Health Care Survey (CEHCS), sponsored by EBRI and Mathew Greenwald Associates, show that average account balances leveled off in 2008 and 2009, and fell slightly in 2010, but increased in 2011 and 2012. Specifically, average account balances rebounded to $1,470 in 2011, up 9% from 2010, and to $1,534 in 2012, up 4%.

In 2012, there was $17.8 billion in HSAs and HRAs, spread across 11.6 million accounts. This was up from 2006, when there were 1.3 million accounts with $873.4 million in assets, and 2011, when 8.5 million accounts held $12.4 billion in assets.

Other survey findings:

• Healthy behavior by owners of these health accounts does not mean they have higher balances. There was little difference in account balances by level of exercise. Next to no relationship was found between either account balance or rollover amounts and various cost-conscious behaviors.
• Men have higher account balances than women, older individuals have higher account balances, account balances increase with household income, and education has a significant impact on account balances independent of income and other variables.
• Rollover amounts increased with household income and education, and individuals with single coverage rolled over a slightly higher amount than those with family coverage n 2012.

The full report is published in the January 2013 EBRI Issue Brief no. 382 and is available online.