Pressure to hold down health care costs gave health savings accounts (HSAs) and health reimbursement arrangements (HRAs) a big boost in 2011.

The number of U.S. adults ages 21 to 64 with either an HSA HSA or an HRA increased to 8.4 million last year, up from 5.4 million in 2010, according to Paul Fronstin, a researcher at the Employee Benefit Research Institute (EBRI), Washington.

Fronstin based his analysis on results from a series of health care consumerism surveys organized by EBRI and other organizations.

Total health account assets soared to more than $12 billion, up from $7.3 billion a year earlier, Fronstin says.

The weak job market and weak interest rates and investment returns caused the average health account balance to fall 4.5% in 2010, to about $1,360.

In the average balance increased 8.5%, to $1,470.

Fronstin also found that the health account holders now tend to have more experience with the accounts than they did a few years ago, when the programs were relatively new.

In 2011, 49% of the health account holders had had their accounts for 3 or more years, up from 36% in 2010.

About 31% of the holders have balances of $2,000 or more, up from 29% a year earlier.

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