Analyzing the Intersection of HSAs and Race, Ethnicity, Gender, and Income

This article leverages the Employee Benefit Research Institute’s (EBRI) HSA Database to examine the ways in which HSA usage varies by race, ethnicity, gender, and income. The author finds significant disparities across racial lines. White accountholders made larger contributions and had larger balances than their Black counterparts. Similarly, male accountholders made larger contributions and had higher average balances than female accountholders. This pattern extended to higher-income accountholders relative to lower-income accountholders. To the extent that HSAs are not used properly, they may reinforce existing health inequities.