Millions newly eligible for HSAs in 2026 after rule change Image By HPN Staff Key Points Beginning Jan. 1, 2026, millions more Americans will qualify for Health Savings Accounts (HSAs) because the One Big Beautiful Bill reclassifies ACA Bronze and Catastrophic plans as high-deductible health plans (HDHPs), opening HSA eligibility to 7.25 million newly qualified enrollees. Rising healthcare costs are driving the urgency of HSA expansion, with employer benefit costs increasing 6% in 2025 and projected to rise 6.7% in 2026, the biggest jump in 15 years — making tax-advantaged medical savings more valuable to families. Policymakers argue HSAs empower patients and reduce costs, with Sen. Bill Cassidy proposing pre-paid HSAs for ACA enrollees and experts testifying that HSAs can reduce family healthcare spending by 15–25% without harming health outcomes. For more than two decades, Health Savings Accounts (HSA) have allowed Americans to save money on qualified medical expenses through tax-free contributions and withdrawals, with balances rolling over each year and growing through investments. Beginning Jan. 1, 2026, more participants will be able to use HSAs to tackle growing healthcare burdens than ever before. The One Big Beautiful Bill (OBBB), passed by Congressional Republicans and signed by President Donald Trump this summer, expanded HSA eligibility. The OBBB reclassified Bronze and Catastrophic Affordable Care Act (ACA) Marketplace plans as qualifying high-deductible health plans (HDHPs) for 2026. According to the White House Council of Economic Advisers, this reform will unlock access for approximately 7.25 million Americans who were previously ineligible for HSAs. Morningstar estimates that 3-4 million Americans could add HSAs to their portfolios in 2026. Why it matters Health benefit costs are rising much faster than inflation and wage growth, according to a new Mercer report. Cost burdens rose 6% in 2025 and are projected to jump 6.7%, the largest increase in 15 years, in 2026. Designed to help Americans with these ever-increasing health care costs, HSAs allow individuals and families with HDHPs to use pre-tax dollars to pay for out-of-pocket medical expenses, reducing taxable income and easing financial strain. Unlike Flexible Savings Accounts (FSA), HSAs can be rolled over year to year and invested, similar to 401(k) plans and other retirement accounts. According to Devenir, Americans hold 40 million HSAs with assets worth $159 billion. The bigger picture Amid the furor over the coming expiration of expanded Obamacare premium subsidies, Sen. Bill Cassidy (R-La.) has proposed allowing those enrolled in ACA Bronze Plans to receive pre-paid HSAs instead, arguing the subsidies mostly benefit large insurers, not patients. “Under the status quo, the insurance companies get the money that subsidizes premiums, the insurance company makes the decision and it doesn’t lower health care costs,” Cassidy said at a Senate Finance Committee hearing last month. “In fact, it actually contributes to higher costs, and it fuels fraud and unauthorized enrollment. Under what we’re proposing, 100% goes to a patient-driven account.” Yes, and Also at the hearing, Paragon Health Institute President Brian Blase testified that HSAs normally reduce a family’s healthcare spending by 15-25% without eroding health outcomes. Blase said, “When they have that control, Americans can be wise consumers and make good decisions about what’s in the best interest of their health.” SUGGESTED STORIES Many skip doctor visits and prescriptions, new data shows More than a third of Americans are skipping or postponing doctor visits and other needed health care due to high cost, according to recent polling from the Kaiser Family Foundation (KFF). In a related trend, more than 20% of patients have not fi Read more Bill seeks to protect the data gained from health-tracking wearables With the popularity of wearable health devices growing, so too are the concerns about ensuring the privacy of the data that those trackers gather. Sen. Bill Cassidy (R-LA) has introduced a bill designed to expand data privacy protections to include gadgets such as fi Read more If caught early, cancer survival rates increase exponentially This is a lightly edited excerpt of testimony recently provided to the U.S. House’s Energy and Commerce Health subcommittee hearing "Examining Policies to Enhance Seniors’ Access to Breakthrough Medical Technologies." In 2022, I was diagnosed with pancreatic cancer, Read more
Many skip doctor visits and prescriptions, new data shows More than a third of Americans are skipping or postponing doctor visits and other needed health care due to high cost, according to recent polling from the Kaiser Family Foundation (KFF). In a related trend, more than 20% of patients have not fi Read more
Bill seeks to protect the data gained from health-tracking wearables With the popularity of wearable health devices growing, so too are the concerns about ensuring the privacy of the data that those trackers gather. Sen. Bill Cassidy (R-LA) has introduced a bill designed to expand data privacy protections to include gadgets such as fi Read more
If caught early, cancer survival rates increase exponentially This is a lightly edited excerpt of testimony recently provided to the U.S. House’s Energy and Commerce Health subcommittee hearing "Examining Policies to Enhance Seniors’ Access to Breakthrough Medical Technologies." In 2022, I was diagnosed with pancreatic cancer, Read more
