HSAs are frequently criticized for exacerbating inequality in healthcare access

As healthcare costs have increased post-COVID, critics have been skeptical about the real impact HSAs/FSAs have had in alleviating medical expenses

Health savings accounts and flexible spending accounts are designed to be tax-advantaged ways for people to save money on healthcare and medical expenses. But one recent study found that HSAs can increase families' total out-of-pocket spending on healthcare by more than $500 per year.

HSAs are triple-tax advantaged—offering tax-free contributions, investments, and withdrawals

One of the reasons HSAs are so popular is the plan's triple-tax advantage. All contributions to an HSA happen pretax, funds in the HSA can be invested in stocks, bonds, or exchange-traded funds, and withdrawals to cover medical expenses are tax-free.

Health savings accounts are designed to alleviate upfront costs for high-deductible health plans.

HSA spending spikes early in the year, while FSA spending peaks in December

Because health savings accounts are designed to alleviate high upfront costs for people with high deductible health plans, the majority of HSA spending happens early in the year. However, around 10% of flexible spending account funds are used in December—right before the use it or lose it deadline.

Trump's 2025 'One Big Beautiful Bill Act' expanded access to health savings accounts

After the "One Big Beautiful Bill" took effect, Medicare users with bronze or catastrophic level health plans, as well as certain medical care membership models and telehealth users, became eligible for HSAs. Supporters of HSAs say expanding access to this savings program is more effective in alleviating high consumer costs than subsidizing healthcare plans or direct treatments.

Health savings accounts evolved out of medical savings accounts introduced in the 1990s

After medical savings accounts in Singapore and South Africa proved successful, the US introduced a pilot program for small business owners and the self-employed to pair with high-deductible health plans in 1996. In 2003, Congress passed a law inspired by that program, and health savings accounts became tax-free and open to anyone with a high-deductible plan. FSAs, on the other hand, date back to the 1970s.

Watch a breakdown of tax breaks most Americans don't know about

Programs like healthcare savings accounts or flexible spending accounts are tax-free accounts that are designed to help lower healthcare costs. However, many Americans don't use them and don't understand how they work.

Read about the situations where a high-yield savings account doesn't make sense

While financial experts often recommend high-yield savings accounts, one expert argues that prioritizing adding more money to one doesn't make sense for someone who has a lot of high-interest debt or isn't taking advantage of their company's 401(k) match.

Flexible spending accounts can't be used to pay for concierge membership fees

FSAs, used by roughly half of Americans, can only cover qualified medical services—so actual care—and cannot be used to cover membership fees for a concierge medicine practice. These fees must be paid out of pocket by clients.

Flexible spending accounts are operated by employers

Unlike health savings accounts, which can be opened at banks and credit unions, FSAs are employer-owned and operated—meaning you can only access an FSA through an employer benefit, and the account doesn't follow you if you move jobs. To use an FSA to pay for a medical service or product, purchases typically have to be uploaded, approved, and then employees can be reimbursed.

Explore a list of surprisingly FSA-eligible wellness products

Flexible spending accounts can be used to cover medical expenses, but those funds can also be used to purchase wellness items or services, like bandages or contact solution. The general guidance for what's FSA eligible is any expense that is designed to diagnose, cure, mitigate, or treat a medical condition. HSA funds can often be used to cover the same expenses. (Some users may experience a paywall.)

Dependent care flexible spending accounts allow people who care for someone incapable of self-care to use pretax dollars to support the dependent person.

80% of Americans are bothered that some wealthy people don't pay their fair share of taxes

That's according to data from Pew Research Center. While most people are primarily taxed on their wages, many people in America's 1% derive much of their income from investments instead, which are often taxed at preferential capital gains rates. This structure was shaped by a series of legislative cuts that began in earnest with the 1978 Revenue Act and the 1981 Economic Recovery Tax Act.

The 401(k) is limited in its ability to provide guaranteed retirement income

Part of the problem is the high, often hidden fees associated with the accounts and a lack of access. Plus, analysts say the annual cost in tax revenue to the government is more than $100B.

The debate over estate taxes centers on wealth inequality

Since the modern federal estate tax was implemented, people have felt strongly about whether or not to keep it. Much of the debate boils down to equality: Proponents say the tax creates better income equality between the rich and poor, while opponents say it's an inequitable tax only placed on the wealthy.

Some politicians have argued that Social Security should be privatized

Specifically, some assert that diverting funds into self-directed retirement accounts should replace Social Security taxes and benefits to some extent in a privatized retirement savings system. This article details the pros and cons of privatizing Social Security.

Private equity's expansion into healthcare has been criticized for raising patient medical costs

Between 2000 and 2018, PE's total investment in healthcare ballooned from $5B to $100B. While healthcare systems originally began consolidating as a solution to navigating complex regulations (and to make working with insurance companies easier), research suggests that private equity has both increased patient costs and decreased the quality of care in hospitals and doctors' offices.

Employers get to keep any FSA funds not used by the annual deadline

Flexible spending arrangements have use it or lose it deadlines defined in the plan. Employers that offer FSAs get to keep any unused funds, but that money has to go towards administering the FSA program. Remaining FSA funds can also be pooled and divided evenly amongst a company's FSA participants, but very few companies actually do this.

Congress didn't renew temporary enhanced Affordable Care Act federal subsidies that expired at the end of 2025, a move that substantially raised ACA health insurance premiums.

Americans spend an average of $200 on tax preparation services like TurboTax and H&R Block

In 2025, about half of Americans were able to file taxes directly with the IRS for free. It was the second year of the agency's new program, which cuts out intermediaries. Though tax preparation has been free for many Americans, critics say tax companies upsell customers.

Some policymakers take issue with long-term capital gains being taxed at a preferential rate compared to income from paid work

The concept of taxing unrealized capital gains—when an asset’s value increases but has yet to be sold—has been increasingly debated. Other policymakers in recent years have supported lowering the highest long-term capital gains tax rate and are generally opposed to levying taxes on unrealized capital gains.

Owning a home can help build wealth via tax benefits and more

In addition to tax benefits and the potential to build equity in your home, houses are also typically considered an appreciating asset. That means their value is likely to increase over time.

Trusts offer ways to reduce the taxes beneficiaries pay on assets in one’s estate

People of different socioeconomic classes often decide to establish a trust to avoid certain taxes. When someone dies and leaves assets to beneficiaries in a will, those beneficiaries must pay specific taxes a trust's beneficiaries avoid. It all depends on the type of trust.

Most Americans take the standard tax deduction

A tax deductible is an expense that a taxpayer or business can subtract from adjusted gross income, reducing their taxable income and therefore reducing the amount of taxes owed. Governments often use tax deductibles as a way to reward people who do things that are considered beneficial to society, like charitable donations.

Financial solutions for HENRYs

The term HENRY stands for "high earner, not rich yet." People who fall into the high earner, not rich yet category tend to have some significant blockers keeping them from accumulating wealth, such as lifestyle creep and student debt. This article outlines some financial planning advice specifically for those in the HENRY category—read it here.

Only half of American workers have retirement accounts, like 401(k) plans, through their current jobs.

Inside the lives of HENRYs

The acronym "HENRY" stands for "high earner, not rich yet." The phrase is becoming more popular as new census data shows that roughly 14% of US households bring in $200K or more per year. This article dives into the lives of a few HENRYs and explains the factors keeping them from increasing their respective net worths, from child care costs to rising housing prices. Read it here.

A rising number of Social Security beneficiaries are taxed on their Social Security income

That’s because while Social Security benefits increase with wages and inflation, the income limits for taxing those benefits stay the same and don’t adjust over time.

The scope of 529 plans has expanded, but 529s still have some drawbacks

The tax-advantaged accounts can be used to pay for K-12 education, apprenticeship programs, and student loans, in addition to their original purpose: paying for college. But 529s have downsides, such as fees and penalties for non-qualified uses.

Special needs trusts help financially care for dependents with disabilities.

Half of the richest people in the US are finding ways around death taxes

One of the main purposes of the federal estate tax is to crack down on generational wealth, so wealth isn't concentrated among a select few. However, the ultra-rich have found ways around paying these taxes. This ProPublica article investigates the practices used by half of the 100 richest people in the US to avoid death taxes.

Read why the information Americans have about our tax system might be misleading

For many, filing taxes can be complicated and overwhelming. Some argue that the tax system obscures certain aspects of the US tax code, making it difficult for taxpayers to accurately assess potential reforms.

Americans between the ages of 45 and 55 pay nearly 30% of all income taxes, paying an average tax rate of around 17%.

Some argue that credit reporting promotes economic inequality in the US

Although today's credit scoring system is much more objective than, say, the credit assessment system of the 1700s, some argue there's still room for improvement, with critics saying the current system is still discriminatory. For example, while mortgage payments have long been automatically reported to credit bureaus, rent payments (the primary housing expense for most lower-income Americans) historically haven't been reported unless a payment was missed.

Learn about loopholes in the American tax code, which involve everything from cat food to death to heavy machinery.

Having two retirement accounts has its pros and cons

Contributing to both an IRA and a 401(k) lets you increase your retirement savings by about 30% every year. However, you’ll also spend more time actively investing that money and pay more in fees.

Why the rich don't pay taxes like you do

The system behind the US income tax isn't as straightforward as it looks. You earn money. Taxes get taken out. Case closed … right? Not exactly. In this episode of "1440 Explores," we break down how the US tax system actually works, from confusing deductions and misunderstood tax brackets to why the wealthiest Americans often end up paying a very different tax than everyone else.

The Social Security Administration (SSA) accounted for 22.4% of all federal spending in 2024

The SSA is an independent executive branch agency that is primarily responsible for administering Social Security benefits. In fiscal year 2024, The SSA, ranking second among federal agencies in terms of total spending, behind only the Department of Health and Human Services.

Contrary to popular belief, trusts aren’t only for the wealthy

Trust funds can be expensive to set up, given that their establishment often requires paying a lawyer for their time. But for many, that expense might be worth it depending on the complexity of the assets and the ability to specify when, where or how an estate’s assets are used.

Some argue that a massive emergency fund can hurt more than it helps

A financial advisor makes the case for an emergency fund that isn't too overstuffed. An emergency fund that is too large, he argues, can mean that you'll miss other opportunities to grow your wealth.

A 401(k) plan allows workers to save for retirement without paying taxes until later

With a 401(k) plans you can invest more money now and let it grow with compound interest. Americans have more than $7T invested in these types of accounts.

Some multibillion-dollar pension funds depend on hedge funds

Pensions are responsible for safeguarding the retirement plans of many corporate and government employees alike. Pensions differ from 401(k) plans and sometimes rely on alternative assets, like hedge funds, to insulate their portfolios of billions of dollars from volatility in financial markets. Read the case top pension advisor Cambridge Associates makes for hedge funds.

Fees can eat away at your 401(k)

Every investment plan has an expense ratio—a percentage of the total assets that goes to the investment manager in the form of fees. Because 401(k) plans are so common, and many of their participants are not savvy investors, the relative expense ratio for them has often excessively increased.

American CEOs are so wealthy in part because of stock buybacks, the process of a company purchasing shares of its own stock.

Retail investors are getting burned by long/short strategies

In the US, many retail investors lack the SEC-mandated status (a high enough net worth, income, and other factors) to directly invest in hedge funds. The regulator considers hedge funds too risky for the masses. Hedge fund-like strategies have emerged as a workaround, despite potential pitfalls.

Warren Buffett paid a lower effective tax rate than his secretary

While wages and salaries are taxed progressively at rates up to 37%, long-term investments are taxed at lower rates: 0%, 15%, or 20%. For wealthy individuals like Buffett, whose income mainly comes from investments, this means paying a lower effective tax rate than someone earning a salary.

Hedge funds make money from imposing steep fees on investors, as well as from investment performance

Hedge funds often operate on a "2 and 20" model: Investors pay fund managers a 2% management fee, and the hedge fund keeps 20% of their profits. (The 2% is imposed annually, irrespective of performance.) Hedge funds are known for chasing big returns—and taking big risks to get them. This explainer not only breaks down how they work in detail, but also the strategy first introduced in 1949 that still shapes hedge fund investing today.

The pros of exchange-traded funds include ease of access through brokerage apps and retirement savings accounts

One unexpected perk is that ETFs are typically associated with lower capital gains tax requirements. Read this list to learn more about the benefits of investing in ETFs.

Long- and short-term capital gains have different tax implications

Short-term gains (assets held for one year or less) are taxed like regular income, at rates up to 37%. Meanwhile, long-term gains (assets held over a year) are capped at 20%, offering significant savings for high earners.

Prisoners granted compassionate release due to severe illness often stay months—or years—largely because nursing homes are reluctant to take prisoners.