Sometimes benefits law is also written by the rich for the rich. Vanishingly few non-rich can come anywhere near maxing out tax-advantaged retirement accounts, even if they have the spare cash to do it (too much of the limit has to come from your employer), meanwhile the rich can easily structure their income to max it out (and max out their spouse's, and their kids', et c.). The most-effective use of health savings accounts is also as a stealth tax-advantaged retirement account for the rich (the trick is you put money in, pay any actual medical expenses with ordinary taxed money outside the account, then at retirement the HSA money that would have gone to those bills, but didn't, and has been invested and growing all this time, can come out tax-free as long as you—or your accountant—kept the receipts)