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A summary of the articles included in the February 2026 edition:

  • HSA Deposit Rate Update – December 2025
  • Despite Rising Healthcare Costs, HSA Account Balances Hit Record High
  • Marketplace 2026 Open Enrollment Period Report: National Snapshot
  • When HSA Dollars Enter Direct Primary Care, Control Follows
  • Policy Changes Bring Renewed Focus on High-Deductible Health Plans


HSA Deposit Rate Update – December 2025

During the fourth quarter of 2025, data collected from HSA Search indicated HSA deposit rates were unchanged across balance tiers, with the exception being the $1,000 threshold, which increased 0.01%. The $1,000 balance rose from 0.45% to 0.46%, while the $10,000 and $25,000 balance tiers remained constant at 0.55% and 0.60%, respectively. Analysis of the last three quarters reveals that the lowest balance tier increased at a faster rate compared to higher balance tiers. This pattern may indicate providers are strategically adjusting rates to incentivize new account holders with lower initial balances.

Despite Rising Healthcare Costs, HSA Account Balances Hit Record High

Lively revealed another record year for average HSA balances even as U.S. healthcare costs continue to climb.

As employers and households grapple with historic premium increases, higher deductibles, and rising out-of-pocket healthcare expenses, Americans are increasingly turning to Health Savings Accounts (HSAs) as a critical financial tool to manage both near-term medical costs and long-term healthcare planning. Against this backdrop of persistent cost pressure and economic uncertainty, Lively’s data highlights how effective HSA engagement can help account holders build greater financial resilience.

Marketplace 2026 Open Enrollment Period Report: National Snapshot

The Centers for Medicare & Medicaid Services (CMS) reports that 23.0 million consumers have signed up for 2026 individual market health insurance coverage through the Marketplaces since the start of the 2026 Marketplace Open Enrollment Period (OEP) on November 1, 2025. This includes 15.8 million Marketplace plan selections in the 30 states using the HealthCare.gov platform for the 2026 plan year and 7.2 million plan selections in the 20 states and the District of Columbia with state-based Exchanges (SBEs) that are using their own eligibility and enrollment platforms. Total nationwide plan selections include 3.4 million consumers who are new to the Marketplaces for 2026, and 19.6 million consumers who had active 2025 coverage and selected a plan for 2026 coverage or were automatically re-enrolled.

When HSA Dollars Enter Direct Primary Care, Control Follows

As of January 1, 2026, Health Savings Account funds can be used to pay for Direct Primary Care (DPC) memberships. For a while, this change has been framed as an access milestone. In practice, it is a market design event.

Policy shifts rarely operate in isolation. When tax-advantaged dollars enter a care model, they do more than expand purchasing power. They reorganize incentives, accelerate intermediary involvement, and clarify who holds leverage. The weeks leading up to January 1 have already shown platforms, benefit vendors, and provider groups positioning aggressively in anticipation of the funding shift.

The HSA rule change does not simply make DPC more affordable. It transforms DPC from a care relationship into a financial product category. And once that shift occurs, control follows infrastructure.

Policy Changes Bring Renewed Focus on High-Deductible Health Plans

The expiration of the Affordable Care Act’s enhanced premium tax credits, along with the passage of the budget reconciliation law, implementation of new Marketplace regulations, and other administrative changes, could bring significant changes to ACA Marketplace enrollment and affordability for the 2026 plan year and beyond. Anticipated increases in what enrollees pay for premiums and new standards for HSAs could lead some consumers to consider plan options with lower premiums in exchange for higher deductibles, such as catastrophic or bronze plans. This Kaiser Family Foundation issue brief examines key features of bronze and catastrophic plans, recent policy changes, coverage and costs, and the complicated choices for consumers.