Colorado Democratic congressional candidate Manny Rutinel greets Ariella Thomas during Protect Our Care's "Sick Of It" nationwide bus tour, in Denver, Colorado, Oct. 26, 2026.

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Healthcare affordability was part of the midterm election cost-of-living debate .

It is uncertain how a new Congress might try to address that pain point. Now, as workers choose their 2027 health insurance coverage , millions face a more immediate decision: whether to pick a plan that lets them contribute to a health savings account, or HSA.

The question is whether an HSA-eligible plan with lower premiums and tax benefits is worth the higher deductible and potential out-of-pocket costs.

HSAs come with a 'triple tax advantage'

One noted advantage of an HSA is its tax benefits.

"You have a triple tax advantage," said Kalei Cadinha-Pua'a, vice chair and CEO of Honolulu-based Cadinha & Co., which ranked No.…