Employers across the United States are borrowing a strategy long used in retirement savings to push more workers into health savings accounts. The approach, known as automatic enrollment, has been a fixture of 401(k) plans for years. Now it is showing up with increasing frequency in HSA programs tied to high-deductible health plans.
According to CNBC, nearly 46% of employers automatically opted workers into an HSA when the employee enrolled in a high-deductible health plan in 2025. That figure comes from a report published in August by the Plan Sponsor Council of America, a trade group representing employers. In 2019, the share was 32%.
HSAs carry a three-part tax benefit. Money contributed does not count toward taxable income. Investments inside the account grow tax-free. And withdrawals for qualified health expenses are also tax-free. Despite those advantages, participation has historically been lower than many employers would like when employees have to opt in on their own.
"I think that we've seen a lot of success with automatic features in retirement plans," said Hattie Greenan, the PSCA's director of research and communications. "And employers are looking at how they can adopt that with other benefits."
For comparison, about 64% of employers auto-enrolled workers into a 401(k) plan in 2025. A federal retirement law called Secure 2.0, passed in 2022, required most newly formed 401(k) plans to begin auto-enrolling workers starting last year.
The HSA auto-enrollment model differs in one notable way from 401(k) auto-enrollment. In a 401(k) plan, employers typically deduct a percentage of each paycheck automatically, often 3% or 6%, and direct those funds into the account. That setup is rare among HSA plans. Instead, employers that auto-enroll workers into HSAs typically make their own contribution to seed the account.
About 77% of employers provided employees with an HSA contribution in 2025, according to PSCA data. In that setup, auto-enrollment becomes a way for employers to make sure workers actually receive and can use the employer contribution.
"If you rely on individuals to open their own accounts, it's much more difficult" to increase participation, said Ann Brisk, senior managing director of strategy and innovation at HSA Bank, which administers health savings accounts.
Rising health care costs are part of what is driving employer interest in the strategy. Experts say employers see seeding HSA accounts through auto-enrollment as a way to help workers cover expenses at a time when out-of-pocket costs continue to climb.
"I think there's a recognition that health care is expensive, and supporting employees with that is essential," Greenan said.
High-deductible health plans carry deductibles of at least $1,700 for individuals and $3,400 for families in 2026, according to IRS guidelines. Those thresholds mean workers on such plans can face significant costs before insurance coverage begins, making the HSA a practical tool for bridging that gap.
About a third of employers that make a contribution, 32%, do so in a structure that mirrors 401(k) paycheck deductions. The broader trend points toward employers treating HSAs more like retirement vehicles, using the same behavioral design principles that have made 401(k) auto-enrollment a standard part of workplace benefits.
