Enrollment in HSA, HRA plans drop to 15%

Marketers are having a tougher time selling high-definition health plans together with health accounts, and they’re having a tougher time getting workers to focus on the health account offers.

The percentage of U.S. adults with a combination of HDHP coverage and a health savings account or health reimbursement arrangement fell to 15% in 2025, according to new survey data from the Employee Benefit Research Institute and Greenwald Research.

That was down from 18% in 2024, after EBRI and Greenwald reported 18%-19% for every year from 2020 through 2023.

The people who took the survey had a tougher time answering the question: The percentage who could not remember whether they had been offered HRAs or HSAs increased to 14%, from 11%.

The percentage of participants who said they were extremely, very or somewhat familiar with “consumer-directed healthcare” or “consumer-driven healthcare plans” fell to 67%, from 76%.

See also: How to help workers of all ages use—and gain value—from HSA accounts

81% of survey takers had health coverage through work

The survey: EBRI and Greenwald based the data on results from an online survey conducted in late 2025. The sample included 2,001 people ages 21 through 64.

About 81% of the survey participants had employer-sponsored health coverage.

The questions about HDHPs and health accounts were part of a survey questionnaire that was designed to measure consumer engagement in healthcare and health coverage decisions.

What it means: Employers and benefits advisors are talking a lot about employee engagement systems and programs, but the systems and programs may not be working very well.

This article was originally published on BenefitsPRO, a sister site of HR Executive. For more content like this delivered to your inbox, sign up for BenefitsPRO newsletters here.

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