Americans Contributed Less to Their Health Savings Accounts in 2014

Contributions from employers and workers to health savings accounts (HSAs) were on the decline in 2014, according to new research from the Employee Benefit Research Institute (EBRI).

Last year, nearly a quarter of employers with 10-499 workers and almost half with 500 or more workers offered either HSA- or health reimbursement arrangement (HRA)—eligible plans. Overall, 15% of the privately insured market was covered by these plans.

After hitting a record high level of employer contribution into HRA or HSA accounts (71%) in 2013, only 67% of workers reported their employers contributed to these accounts in 2014.

“The percentage of workers reporting that their employers contribute to the account decreased slightly in 2014, the first such decrease since 2009,” the authors wrote. “However, among those with employer contributions, overall contribution levels for individuals with employee-only coverage increased from 23 percent to 34 percent in 2014.”

Between 2011 and 2014, the proportion of individuals reporting they contributed nothing to their HSA increased from 11% to 23% while the percentage reporting they contributed $1500 or more fell from 44% to 30%.

Among workers with individual coverage and employer contributions the percentage with contributions of $200-$999 decreased, but those with contributions of $1000 or more increased in 2014.

How long an individual has had an account has an impact on individual contributions among those with employee-only coverage, according to the report. Workers with an HSA for less than 3 years contributed less than those with an HSA for 3 years or more. Among workers with an HSA for at least 3 years, 37% contributed $1500 or more in 2014 compared with 25% of individuals with an account for less than 3 years.

In addition, there was a correlation between health engagement and individual contributions. According to the EBRI report, workers who were engaged in their health did at least one of the following:

• Checked whether a health plan covered their care or medication
• Checked the price of a doctor’s visit, medication, or other health service before receiving care
• Checked the quality rating of a doctor or hospital before receiving care
• Talked to their physician about prescription options and costs
• Talked to their physician about other treatment options and costs
• Used an online cost tracking tool provided by their health plan to manage expenses
• Developed a budget to manage their healthcare expenses
• Asked for a generic drug instead of a brand name drug
• Asked their physician to recommend a less costly prescription drug

These more highly engaged workers contributed more money to an HSA. While 40% of those with no engagement in the healthcare system contributed $1500 or more, compared with 49% of those with at least some engagement.