High deductible health plans and health savings accounts

Healthcare expenditures are a large component of the average household budget in The United States1. While 

household healthcare insurance expenditures nearly doubled between 2010 ($1,831) and 2018 ($3,405),

employer healthcare costs increased by 22.3 percent2

. 

This factsheet highlights High Deductible Health Plans (HDHP) and Health Savings Accounts (HSA) estimates for 

private industry workers from the National Compensation Survey (NCS). 

The availability of HDHPs for private industry workers participating in medical care plans increased from 24 

percent in 2010 to 45 percent in 2018. (See chart 1.)

HDHPs typically have higher deductibles and lower premiums than traditional (nonhigh deductible) health plans. 

In 2018, the median annual deductible for private industry workers participating in HDHP plans was $2,000.00. 

For private industry workers participating in non-HDHP plans, 16 percent did not have a deductible. For the 84 

percent with a deductible the median annual deductible was $500.00. (See chart 2.) 

0%

25%

50%

75%

100%

All workers Management,

professional, and

related

Sales and office All workers Management,

professional, and

related

Sales and office

2010 2018

Source: U.S. Bureau of Labor Statistics, National Compensation Survey

Chart 1. Availability of high deductible health plans for private industry workers 

participating in medical care plans

High deductible Nonhigh deductible (traditional plans)

$0 $500 $1,000 $1,500 $2,000 $2,500 $3,000 $3,500 $4,000 $4,500 $5,000

10th percentile

25th percentile

50th percentile (median)

75th percentile

90th percentile

Source: U.S. Bureau of Labor Statistics, National Compensation Survey

Chart 2. Annual deductible amount for private industry workers participating in 

medical plans, 2018

Nonhigh deductible plans High deductible plans
National Compensation Survey • www.bls.gov/ebs • NCSinfo@bls.gov • 202.691.6199

HDHPs allow workers to establish Health Savings Accounts (HSA), which are employee-owned and used to pay 

for medical expenses with pretax contributions. Additionally, HSAs may earn tax-free interest and unused 

contributions roll over from year to year.

Access to HSAs increased from 14 percent in 2010 to 30 percent in 2019 for private industry workers. In 2010, 7 

percent of workers in small establishments (fewer than 50 workers) had access to HSAs, increasing to 18 percent 

in 2019. In 2019, 47 percent of workers in the largest establishments (more than 500 workers) had access to 

HSAs. (See chart 3.) 

Access to HSAs also increased by wage category. Six percent of workers in the lowest 25 percent wage category 

had access to HSAs in 2010 and 13 percent had access to HSAs in 2019. For workers in the highest 25 percent

wage category HSA access increased from 20 percent in 2010 to 48 percent in 2019. (See chart 4.) 

Access to HSAs varied by certain worker characteristics. For example, 14 percent of nonunion workers had 

access to health savings plan, compared with 12 percent of union workers in 2010. In 2019, 30 percent of

nonunion workers had access while 27 percent of union workers had access to HSAs. More full-time workers had 

access to HSAs than their part-time counterparts (16 percent compared with 6 percent) in 2010 and (36 percent 

compared with 11 percent) in 2019. Access to HSAs varied by other worker and establishment characteristics 

published by the NCS. 

0%

10%

20%

30%

40%

50%

2010 2011 2012 2013 2014 2015 2016 2017 2018 2019

Source: U.S. Bureau of Labor Statistics, National Compensation Survey

Chart 3. Percentage of private industry workers with access to Health Savings 

Accounts by establishment size

All workers Less than 50 workers 100-499 workers 500 workers or more

0%

10%

20%

30%

40%

50%

60%

2010 2011 2012 2013 2014 2015 2016 2017 2018 2019

Source: U.S. Bureau of Labor Statistics, National Compensation Survey

Chart 4. Percentage of private industry workers with access to Health Savings 

Accounts by wage categories

Lowest 25 percent Second 25 percent Third 25 percent Highest 25 percent
National Compensation Survey • www.bls.gov/ebs • NCSinfo@bls.gov • 202.691.6199

Whether an HDHP will save participants money depends on a variety of factors. The increased availability of 

HDHPs and HSAs provides employers and employees with additional flexibility to manage the cost of health 

care. 

Additional resources:

• Latest news release

• Archived benefits news releases

• Glossary of benefit terms

Factsheets

• Who receives paid vacation leave? (PDF)

• What statistics does the BLS provide on frozen defined benefit plans? (PDF)

• Paid sick leave: What is available to workers? (PDF)

• Flexible benefits in the workplace (PDF)

• Flexible work schedule and student loan repayment

• Medical care premiums in the United States, March 2019

• What data does the BLS publish on family leave?

• Holiday profiles

• Access to paid personal leave

• Unmarried domestic partner benefits, March 2013 (PDF)

Articles

• Union workers more likely than nonunion workers to have retirement benefits in 2019

• 77 percent of private industry workers offered retirement benefits participated in them in 2019

• 51 percent of private industry workers had access to only defined contribution retirement plans

• The last private industry pension plans: a visual essay, 2012 (PDF)

• Changing landscape of employment-based retirement benefits, 2011 (PDF)

• Alternatives to frozen defined benefit pension plans, 2009 (PDF)

The glossary of employee benefit terms provides definitions for plans, provisions, coverage, and related terms. 

The National Compensation Measures Handbook of Methods provides information on the survey design, 

calculations, weighting, and imputation methods used to produce compensation estimates. The calculation 

section includes information on the measures of reliability available for each estimate.

Historical data

Estimates on the cost, coverage, and provisions of employer–sponsored benefit plans from 2010 to 2019 are 

available through the Excel dataset, and public database. Historical data are available on the publications page. 

Benefit estimates are not a time series and users are advised to consider changes in survey design, survey scope, 

estimation methods, weighting, and sample rotation when analyzing the data.

1 Based on the 2018 Consumer Expenditures Survey total average annual expenditures (CXUTOTALEXPLB0101M) and health 

insurance (CXUHLTHINSRLB0101M) series. 2 The Employment Cost Index provides measures of change in the cost of employer paid benefits. See the health benefits 

chart for additional explanation of the health insurance series. The percent change was calculated from March 2010 to 

March 2018 using rounded index estimates.