INSURANCE
Some experts estimated that the change could attract as many as four million new HSA participants. But that was before Congress failed to restore federal subsidies for Obamacare plans, triggering huge increases in their premiums.“ With the current state of affairs, not as many people will be eligible for premium support and, therefore, HSA expansion will be moot,” says Dr. Katy Votava, founder and president of Goodcare. com, a consulting firm in Rochester, N. Y., that specializes in healthcare economics.
She adds that HSAs could use a good marketing push. But because they are not the product of any one company, there’ s little incentive for anyone to spend money publicizing them.
It also would help to decouple them from high-deductible health plans, Votava says.“ I would love to see folks on Medicare and other styles of insurance be able to open an HSA and contribute new funds to it.”
Still, these accounts remain popular in a certain segment of the population. One reason, she says, is that an HSA can stay with the participants for life, even after they change jobs or health plans. They won’ t be allowed to contribute more dollars if they move to an ineligible health plan, including Medicare, but the assets can keep growing tax-free.
The plans are custodied at a financial institution, just like a regular savings account, and contributions can be made through a payroll deduction or separately; an IRA can be rolled over directly to an HSA penalty- and tax-free, Votava adds, but only once. For 2026, the contribution maximum( as set by the IRS) increases by $ 100 to $ 4,400 for individuals and to $ 8,750 for families. Those 55 and older can put in an extra $ 1,000( which is unchanged from 2025).
Year to year, clients can switch between an HSA-eligible plan and more traditional coverage if, say, they are growing their families, anticipate needing medical procedures or have some other need coming up that would be better served with a different insurance plan. Changing plans does not affect the HSA savings or growth potential.“ This flexibility is a huge benefit,” says Goldstein.“ Letting HSA assets grow can unlock decades of tax-advantaged compounding.”
The One Big Beautiful Bill also lets HSA funds keep paying for telehealth services— i. e., doctor appointments online or by telephone— even before clients meet their plan’ s deductible.
Other Changes For 2026
The One Big Beautiful Bill also lets HSA funds keep paying for telehealth services— i. e., doctor appointments online or by telephone— even before clients meet their plan’ s deductible. Such uses of the funds were first allowed during the pandemic, but the option was set to expire at the end of 2025. Now it’ s been made permanent.
This alone could be a game-changer for HSAs, says James Gelfand, president and CEO of the ERISA Industry Committee, a Washington, D. C.-based lobbying group for large employers who offer workplace benefits. Almost as soon as the option became available during the pandemic, millions of participants began to use the benefit, he says, especially to see primarycare providers and mental-health practitioners who may not have been nearby. Altogether, it improved health outcomes and encouraged preventative care that helped keep patients out of the hospital.
“ Many patients have stayed away from [ high-deductible health plans ] primarily because they don’ t want to be exposed to high up-front costs for provider visits,” Gelfand says.“ Now they don’ t have to make that harsh trade-off. [ They can ] get free telehealth visits and primary care.”
The new law also made permanent the use of HSA money for direct primary care by patients who pay a monthly or annual subscription fee to their doctor. The maximum allowable distribution for this service is $ 150 per month for individuals or $ 300 monthly for families.
This model of care is“ incredibly popular among patients and providers,” Gelfand says.“ Patients love that they can see their doctors without feeling nickel-anddimed, and doctors love that they can do what they love without watching the clock in eight-minute increments or focusing on billable hours.”
He expects the inclusion of this care to have a huge impact on HSA enrollment in the year ahead.“ With this barrier gone, we expect that [ this kind of primary care ] will skyrocket and HSAs will grow rapidly,” he says.
Advisors caution, however, that clients should consider what is and isn’ t included in the coverage before choosing an eligible health plan, since that will give them a better sense of what a plan will actually cost( more so than simply comparing monthly premiums). When it comes to choosing an HSA, clients ought to consider factors such as any monthly account fees, what kind of investment options are available and how much interest is paid.
“ The new HSA eligibility rules open the door for millions to fund a health savings plan without changing their health coverage,” says Joe Calhoun of Quotient Wealth Partners in Denver.“ That said, the availability of this savings vehicle is generally only helpful if you have the cash flow to justify the contributions.”
If premium increases remain as drastic as they so far seem to be, the expanded benefits of HSAs won’ t be enough to attract clients, he adds. Affordability is the primary driver of enrollment.
46 | FINANCIAL ADVISOR MAGAZINE | JANUARY / FEBRUARY 2026 WWW. FA-MAG. COM