HSAs were first introduced in 2003 to help offset out-of-pocket costs that often come with HDHPs, which had been growing in popularity. And their growth hasn’t slowed. The average premium for family coverage has increased 22% over the last five years and 55% over the last ten years, forcing more folks to choose HDHPs to save. These types of health plans typically have lower monthly premiums, but also have higher deductibles. The low monthly costs are appealing but can leave a dent in peoples’ pockets if a small medical emergency pops up.