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Bureau of Labor Statistics > Employee Benefits > Publications > Factsheets

High deductible health plans and health savings accounts

Healthcare expenditures are a large component of the average household budget in the United States⁽¹⁾. While household healthcare insurance expenditures grew over 70 percent between 2013 ($2,229) and 2022 ($3,843), employer healthcare costs increased by 23 percent between 2014 and 2023⁽²⁾.

This factsheet highlights High Deductible Health Plans (HDHP) and Health Savings Accounts (HSA) estimates for private industry workers from the National Compensation Survey (NCS)⁽³⁾.

The availability of HDHPs for private industry workers participating in medical care plans was 33 percent in 2014 and 51 percent in 2023. Among private industry nonunion workers, access to HDHP plans was 37 percent in 2014 and 54 percent in 2023. For union workers, access to HDHP plans was 8 percent in 2014 and 35 percent in 2023. (See chart 1).

Table 1. Availability of high deductible health plans for private industry workers participating in medical care plans by bargaining status
Worker characteristic	2014	2023
All workers	33%	51%
Nonunion	37%	54%
Union	8%	35%
Source: U.S. Bureau of Labor Statistics, National Compensation Survey

HDHPs typically have higher deductibles and lower premiums than traditional (nonhigh deductible) health plans. In 2023, the median annual deductible for private industry workers participating in HDHP plans was $2,500. For private industry workers participating in non-HDHP plans, 18 percent did not have an annual individual deductible. For the 82 percent with a deductible, the median annual deductible was $750. (See chart 2).

Table 2. Annual deductible amount for private industry workers participating in medical plans, 2023
Plan	10th percentile	25th percentile	50th percentile (median)	75th percentile	90th percentile
High deductible	$1,500	$1,600	$2,500	$3,500	$5,000
Nonhigh deductible	$250	$500	$750	$1,000	$1,200
Source: U.S. Bureau of Labor Statistics, National Compensation Survey

HDHPs allow workers to establish Health Savings Accounts (HSA), which are employee-owned and used to pay for medical expenses with pretax contributions. Additionally, HSAs may earn tax-free interest and unused contributions roll over from year to year.

Access to HSAs increased from 22 percent in March 2014 to 36 percent in March 2023 for private industry workers. In March 2014, 14 percent of workers in establishments with less than 100 workers had access to HSAs, increasing to 25 percent in March 2023. The percentage of workers with access to HSAs in establishments of 500 workers or more was 33 percent in March 2014 and 56 percent in March 2023. (See chart 3).

Table 3. Percentage of private industry workers with access to Health Savings Accounts by establishment size (1)
Year	All workers	Less than 100 workers	100-499 workers	500 workers or more
2014	22%	14%	29%	33%
2015	24%	15%	32%	36%
2016	25%	16%	35%	38%
2017	26%	17%	34%	40%
2018	28%	18%	36%	43%
2019	30%	20%	38%	47%
2020	32%	20%	40%	52%
2021	34%	24%	42%	56%
2022	35%	24%	44%	55%
2023	36%	25%	45%	56%
Footnote: (1) The reference years refer to the month of March.
Source: U.S. Bureau of Labor Statistics, National Compensation Survey

Access to HSAs also increased by wage category. Eight percent of workers in the lowest 25 percent wage category had access to HSAs in March 2014 and 19 percent had access to HSAs in March 2023. For workers in the highest 25 percent wage category, HSA access increased from 34 percent in March 2014 to 57 percent in March 2023. (See chart 4).

Table 4. Percentage of private industry workers with access to Health Savings Accounts by wage categories (1)
Year	Lowest 25 percent	Second 25 percent	Third 25 percent	Highest 25 percent
2014	8%	22%	26%	34%
2015	10%	23%	29%	37%
2016	9%	23%	32%	42%
2017	9%	24%	32%	42%
2018	11%	26%	35%	44%
2019	13%	27%	36%	48%
2020	15%	29%	37%	52%
2021	16%	32%	38%	55%
2022	16%	33%	39%	57%
2023	19%	33%	40%	57%
Footnote: (1) The reference years refer to the month of March.
Source: U.S. Bureau of Labor Statistics, National Compensation Survey

Access to HSAs varied by certain worker characteristics. For example, 22 percent of nonunion workers had access to HSAs, compared with 18 percent of union workers in March 2014. In March 2023, 36 percent of nonunion workers had access while 38 percent of union workers had access to HSAs. More full-time workers had access to HSAs than their part-time counterparts (26 percent compared with 9 percent) in March 2014 and (44 percent compared with 12 percent) in March 2023.

Access to HSAs varied by other worker and establishment characteristics published by the NCS. Whether an HDHP will save participants money depends on a variety of factors. The increased availability of HDHPs and HSAs provides employers and employees with additional flexibility to manage the cost of health care.

Additional resources:

Factsheets

Articles

The glossary of employee benefit terms provides definitions for plans, provisions, coverage, and related terms. The National Compensation Measures Handbook of Methods provides information on the survey design, calculations, weighting, and imputation methods used to produce compensation estimates. The calculation section includes information on the measures of reliability available for each estimate.

Historical data

Estimates on the cost, coverage, and provisions of employer–sponsored benefit plans from 2010 to 2019 are available through the Excel dataset, and public database. Historical data are available on the Annual Summaries of Benefit Coverage and Health and Retirement Plan Provisions pages. Benefit estimates are not a time series and users are advised to consider changes in survey design, survey scope, estimation methods, weighting, and sample rotation when analyzing the data.

END NOTES

⁽¹⁾ Based on the 2022 annual Consumer Expenditures Survey report.

⁽²⁾ The household healthcare insurance expenditures is based on the Consumer Expenditures Survey health insurance (CXUHLTHINSRLB0101M) series. The Employer Costs for Employee Compensation provides measures costs of employer paid benefits and was calculated using the December health insurance cost per hour worked for private industry workers (CMU2150000000000D) series.

⁽³⁾In the NCS, HDHPs are determined based on the individual deductible amount. See the NCS Handbook of Methods and Glossary of Employee Benefit Terms for additional information.

Last Modified Date: April 11, 2024