The IRS has announced new Health Savings Account (HSA) contribution limits for 2026, offering an opportunity to save more. While that’s positive for eligible participants, most employees won’t benefit. Many don’t have access to an HSA-qualified plan and those who do often fail to use it in ways that maximize its long-term financial advantages.

The real problem isn’t the limits. It’s access, education and underutilization.

2026 HSA Contribution Limits

Category	2025	2026	Change
Self-only Contribution Limit	$4,300	$4,400	+$100
Family Contribution Limit	$8,550	$8,750	+$200
Catch-up (Age 55+)	$1,000	$1,000	No change
HDHP Minimum Deductible (Self-only)	$1,650	$1,700	+$50
HDHP Minimum Deductible (Family)	$3,300	$3,400	+$100
Out-of-Pocket Maximum (Self-only)	$8,300	$8,500	+$200
Out-of-Pocket Maximum (Family)	$16,600	$17,000	+$400

These increases reflect routine inflation adjustments. Still, the more pressing question each year is who will actually benefit from them?

Access Remains Limited

According to the Kaiser Family Foundation’s 2024 Employer Health Benefits Survey, just 21% of covered workers are enrolled in an HSA-qualified high-deductible health plan. That’s not 21% of employers offering it — it’s 21% of the workers whose employer offers health coverage.

The distinction is important. Most workers still don’t have access to an employer-sponsored, HSA-compatible plan, and most workers who do have access to such a plan aren’t enrolled there. So, whether that’s the result of limited access, a lack of awareness or a poor plan design, the result is the same, an opportunity missed.

Most Don’t Contribute Enough —  Or At All

Even when workers do have access, they rarely take full advantage:

• Only 14% of HSA account holders contributed the statutory maximum in 2022, according to the Employee Benefit Research Institute (EBRI).
• Plan Sponsor Council of America (PSCA) data shows similar results: just over 10% max out contributions.
• A large percentage of HSA participants don’t allocate their monies in investments other than capital preservation – meaning they miss out on the opportunity for tax-deferred, and potentially tax-free compounding over time.

The majority of HSAs are used as if they were a different form of Health Flexible Spending Account – not as long-term savings tools. That completely undermines their potential.

The Missed Value of a Long-Term HSA Strategy

HSAs offer a unique tax advantage that no other benefit matches:

• Pre-tax contributions via a cafeteria plan.
• Tax-free investment growth.
• Tax-free withdrawals for qualified medical expenses, and
• Post-retirement income and survivor benefits.

HSA assets have immediate, short term, and long term value. Tax-free reimbursement for qualifying medical, dental, vision, hearing and long term care expenses starts the first day you open the HSAs account – and continues indefinitely, throughout retirement. Qualifying medical expenses also include Medicare premiums. And, after age 65, funds can be used for any purpose without a tax penalty (though non-medical withdrawals are subject to income tax). That puts HSA dollars ahead of 401(k)s in terms of flexibility and tax efficiency, particularly for covering healthcare costs in retirement.

According to EBRI projections, consistent annual contributions and investment growth over a 40-year career could result in a Health Savings Account balance of $1 million or more. For middle-income workers, that’s a significant asset and it’s largely going untapped.

Employers Have a Role to Play

Employers offering self-funded consumer-driven plans have a unique opportunity to improve both access and engagement. To make HSAs more effective, employers should consider treating the HSA in much the same manner as the other long term savings vehicle – the 401(k):

• Offer HSA-qualified plans as the default option when appropriate.
• Make meaningful employer contributions (front-load or as a match).
• Auto-enroll employees in HSA contributions, and auto-escalate.
• Educate employees on long-term value, not just short-term cost-sharing.

It’s not just about plan design. It’s about treating the HSA like the powerful financial tool it is.

How aequum Supports a Smarter HSA Strategy

aequum helps plan sponsors make HSA-capable coverage sustainable and defensible. Our services ensure:

• Review, challenge and resolution of inflated medical charges.
• Legal support for participants for balance billing and claim disputes.
• Data and guidance to gain insight into cost drivers and provider practices.
• High-deductible plan designs are financially viable and aligned with long-term value.

aequum not only reduces costs but also helps employers build smarter and more resilient health plans with HSAs playing a key role in that strategy.

Turning Insight into Strategy

The 2026 HSA contribution limits are up but until more employees have access, understand the value and contribute consistently, most won’t benefit or maximize the value. . The missed opportunity is enormous. So is the upside, for those who take action.

Contact aequum today to strengthen your benefits, protect your participants and turn HSAs into a real asset for your workforce.