Young Americans Lead in HSA Adoption But Carry Heaviest Economic Burden, HealthEquity Research Finds

HealthEquity (NASDAQ: HQY) released its inaugural Fall 2025 Healthcare Affordability Pulse surveying 618 employed Americans between June 25 and July 9, 2025.

Rhea-AI Summary

HealthEquity (NASDAQ: HQY) released its inaugural Fall 2025 Healthcare Affordability Pulse surveying 618 employed Americans between June 25 and July 9, 2025. The results show a generational divide: 56% of Gen Z and 50% of Millennials have HSAs versus 35% Gen X and 24% Boomers. Younger workers report higher benefits understanding (Gen Z 53%, Millennials 62%) but greater economic anxiety (Gen Z 84%) and workplace distraction from finances. HSA holders generally show stronger preparedness for routine care (52% vs 46%), larger emergency reserves (29% with ≥$5,000 vs 25%), and are less likely to cut critical care. HealthEquity links education and employer support to improved financial wellbeing.

Positive

• Gen Z HSA adoption at 56%
• Millennial HSA adoption at 50%
• 62% of Millennials report high benefits understanding
• HSA holders: 52% feel prepared for routine healthcare
• HSA holders: 29% have ≥$5,000 emergency reserves

Negative

• Gen Z reports 84% economic concern
• 36% of Gen Z have $500 available for unexpected care
• 46% of Gen Z cut back on mental health services
• Younger workers report greater workplace distraction from finances

Argus Dec 9 session

+1.27% close to close 1.4x rel. volume Open Argus

Details

News Market Reaction – HQY

On Dec 9, the day this news came out, HQY closed 1.27% above the previous close.

Data tracked by StockTitan Argus for the Dec 9 session.

Key Figures

Gen Z HSA adoption: 56% Millennial HSA adoption: 50% Gen Z economic concern: 84% +5 more

Gen Z HSA adoption

56%

Gen Z respondents with HSAs in Fall 2025 survey

Millennial HSA adoption

50%

Millennial respondents with HSAs in Fall 2025 survey

Gen Z economic concern

84%

Gen Z reporting highest economic concern

Low healthcare cushion Gen Z

36%

Gen Z with less than $500 for unexpected healthcare expenses

Low healthcare cushion Millennials

30%

Millennials with less than $500 for unexpected healthcare expenses

Overall economic concern

79%

All respondents concerned about the overall economy

HSA holders routine preparedness

52% vs 46%

HSA holders vs non-holders feeling prepared for routine expenses

Survey sample size

618 respondents

Employed Americans in employer-sponsored health plans, Jun 25–Jul 9, 2025

Historical Context

5 past events · Latest: Dec 03

5 events

1. Dec 03

   Quarterly earnings

   24h Move

   -0.2%

   Reported Q3 revenue and earnings growth with expanding HSA accounts and assets.

2. Nov 13

   AI product update

   24h Move

   -1.0%

   Announced deployment of agentic AI and expedited claims tools to improve support.

3. Nov 05

   Earnings call notice

   24h Move

   -1.8%

   Set date and access details for upcoming Q3 fiscal 2026 earnings release.

4. Oct 14

   Product launch

   24h Move

   +0.9%

   Launched GLP‑1 telehealth and direct HSA enrollment platforms for members.

5. Sep 25

   Leadership update

   24h Move

   +2.0%

   Added senior executives as HSA eligibility expansion created growth opportunities.

24h Move is the share-price change in the day after each event; other market factors may also have contributed.

Key Terms

health savings account, HSA

2 terms

health savings account financial

"HealthEquity (NASDAQ: HQY), the nation's largest health savings account (HSA) custodian..."

A health savings account (HSA) is a personal savings account that lets people set aside money for medical expenses with special tax benefits: contributions reduce taxable income, the money can grow tax-free, and withdrawals for qualified health costs are tax-free. Think of it as a dedicated emergency fund for healthcare that can also be invested like a retirement account. Investors watch HSAs because they can shift how consumers pay for care, create investable pools of assets, and affect employer benefit costs and employee financial stability.

HSA financial

"Gen Z and 50% of Millennials have HSAs, significantly outpacing Gen X..."

A Health Savings Account (HSA) is a tax-advantaged savings account that people use to pay for qualified medical expenses when paired with a high-deductible health insurance plan. Think of it as a personal medical piggy bank that grows tax-free and can be used for doctor visits, prescriptions, and other eligible care. Investors watch HSA growth because rising balances and account use can signal changing consumer healthcare spending, affect insurers, banks, and health-related businesses, and influence demand for medical services and products.

AI-generated analysis. How Rhea-AI works. Not financial advice.

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New Healthcare Affordability Pulse Reveals Generational Divide in Financial Preparedness and Workplace stress

DRAPER, Utah, Dec. 09, 2025 (GLOBE NEWSWIRE) -- As healthcare costs continue to strain American families, HealthEquity (NASDAQ: HQY), the nation's largest health savings account (HSA) custodian by number of accounts*, today released its inaugural Healthcare Affordability Pulse survey results, revealing a striking generational paradox: younger Americans are leading in HSA adoption and benefits engagement, yet they simultaneously report the highest levels of economic anxiety and workplace financial distraction.

The Fall 2025 Healthcare Affordability Pulse surveyed employed Americans and found that 56% of Gen Z and 50% of Millennials have HSAs, significantly outpacing Gen X (35%) and Boomers (24%). Despite this proactive approach to healthcare savings, Gen Z reports the highest economic concern at 84%, and younger workers are significantly more likely to say financial stress affects their workplace performance.

"We're seeing a generation that's financially engaged and taking advantage of tools like HSAs earlier in their careers, but they're also carrying a heavier burden of economic anxiety," said Scott Cutler, HealthEquity President and CEO. "Gen Z and Millennials know they need to save for healthcare and are doing their part, but they’re doing it in a very different economy, one where higher costs and uncertainty are creating real stress that follows them into the workplace. Giving them simple, portable ways to save and pay for healthcare is one of the most important steps we can take to support their financial health.”

Young Americans Lead in HSA Adoption and Benefits Understanding
The research reveals that younger generations are significantly more engaged with their healthcare benefits. Gen Z (53%) and Millennials (62%) report understanding their benefits "very well" or "extremely well" at much higher rates than Gen X and Boomers (both at 47%). This benefits literacy translates into action, with younger Americans more likely to have HSAs and actively use them as part of their financial planning strategy.

However, their financial preparedness tells a more complex story. Gen Z and Millennials are more likely to have less than $500 available for unexpected healthcare expenses (36% and 30%, respectively), while Boomers were significantly more likely to report having over $2,500 in their HSAs.

Economic Anxiety Impacts Younger Workers Differently
While 79% of all respondents report being concerned about the overall economy, the workplace impact varies significantly by generation. Gen X and Boomers are most likely to say finances don't impact their work performance at all (38% and 27%, respectively), while Gen Z and Millennials are significantly more likely to report that financial strain affects their ability to focus and perform well at work.

Healthcare spending priorities also differ by generation. Gen Z is most likely to cut back on mental health services (46%) and preventive care (36%) when budgets tighten, while Boomers and Gen X are more likely to not cut back on healthcare spending at all (40% and 32%, respectively).

"The fact that young people are cutting mental health services first is concerning, especially when we know they're experiencing higher levels of financial stress," Cutler noted. "This is where employer support and benefits education make the biggest difference."

HSA Holders Show Greater Financial Preparedness Across All Generations
Despite generational differences, HSA holders—regardless of age—demonstrate stronger financial readiness for healthcare expenses. Across all generations, HSA holders are more likely to feel prepared for routine healthcare expenses (52% vs. 46%), have larger emergency reserves (29% with at least $5,000 vs. 25%), and are less likely to cut back on critical healthcare services.

The research also reveals that those who understand their benefits "very well" or "extremely well" are more likely to report that their financial situation does not affect their work focus (29% vs. 20% with moderate understanding), a finding that holds true across all age groups.

Exploring Findings and Solutions
"Healthcare affordability is not a niche issue—it's a universal stressor affecting Americans across every demographic and every generation," Cutler continued. "The good news is that HSAs can help improve financial preparedness. But this research makes clear that education and employer support are critical to helping people not just save, but feel more secure—something that feels even more important given that open enrollment is still happening right now for the majority of Americans."

The HealthEquity Healthcare Affordability Pulse tracks American consumer sentiment on healthcare costs, financial preparedness, and economic wellbeing on a biannual basis. The inaugural Fall 2025 edition surveyed 618 employed Americans enrolled in employer-sponsored health plans between June 25 and July 9, 2025.

The full report, including detailed demographic breakdowns and methodology, is available for download at https://info.healthequity.com/fall-2025-healthcare-affordability-pulse.

To explore these findings alongside other emerging benefits trends, HealthEquity will host a complimentary webinar examining affordability, wellbeing, caregiver benefits, and artificial intelligence. Registration for the “Top 4 Benefits Trends to Watch for in 2026” webinar on Thursday, Dec. 11, 2025 at 12 p.m. MT is available here.

About HealthEquity
HealthEquity (NASDAQ: HQY) and its subsidiaries administer HSAs and other consumer-directed benefits for 17 million accounts in partnership with employers, benefits advisors, and health and retirement plan providers who share our mission to save and improve lives by empowering healthcare consumers. For more information, visit www.healthequity.com.

* Devenir 2025 Mid-year HSA Report

Media Contact
Paul Kluding
pr@healthequity.com

FAQ

AI-generated questions and answers. How Rhea-AI works. Not financial advice.

What did HealthEquity (HQY) report in the Fall 2025 Healthcare Affordability Pulse?

HealthEquity surveyed 618 employed Americans (June 25–July 9, 2025) and found younger Americans lead in HSA adoption but report higher economic anxiety.

How many Gen Z and Millennials have HSAs according to HealthEquity (HQY)?

The survey found 56% of Gen Z and 50% of Millennials have HSAs.

What workplace impact did the HQY survey find for younger workers?

Younger workers report greater financial distraction at work, with Gen Z and Millennials more likely to say finances hurt focus and performance.

Do HSA holders show better financial readiness in the HQY survey?

Yes—HSA holders were more prepared for routine care (52% vs 46%) and more likely to have larger emergency reserves (29% ≥$5,000 vs 25%).

Which services are Gen Z most likely to cut when budgets tighten, per HealthEquity (HQY)?

Gen Z is most likely to cut mental health services (46%) and preventive care (36%) when budgets tighten.

When was the HealthEquity Fall 2025 Healthcare Affordability Pulse conducted?

The inaugural Fall 2025 survey was conducted between June 25 and July 9, 2025.