Unfortunately his talk is almost entirely about FSA. Here’s a word of caution about HSA from CNBC: 91% of people with health savings accounts make this mistake

• Just 9% of health savings account owners invest a portion of their funds, according to the Employee Benefit Research Institute. The rest, 91%, hold cash.
• Ideally, savers would treat HSAs like a retirement account, by investing for future health costs in old age.
• However, HSA investing may not be available to everyone. Doing so would mean paying out of pocket for short-term health expenses to let money grow.

The private financial company—which you don’t get to choose—gets its cut as well, in fees, some which are hidden.

I’m currently on an HSA as it seems to be the best option in the current system for someone who is still relatively healthy and doesn’t get sick or need to go to the doctor often.

It’s a gamble we shouldn’t have to be making. We’re healthy until we’re suddenly, unexpectedly not.

I didn't watch the entire video either, but early he talks about HSAs in the context of which types of FSA is available for people on high- deductible plans with an HSA.

HSAs are mentioned towards the middle in listing the complications of FSA variants

This is an actual FSA ‘loophole’. Easily searchable.

I've only been at two jobs that offered an FSA but both had resources explaining clearly that it is use it or lose it. And my personal risk aversion is why I chose an HSA instead. But it seems like a good idea for people to be able to save money by saying "This isn't really income, since I am confident it's only going to a demonstratable health expense. So don't tax me on it." It's like a business expense can be tax deductible, and you are in the business of living. But then you don't get to take home extra money for being under budget. When used correctly, it's a tool to drive down living expenses and is more efficient for lower incomes since it uses a flat max annual deduction.

I don't want to victim blame people that lose money by overcommitting, but it's not like this is in fine print. You can get short articles that explain it in simple terms just by googling "fsa" before committing thousands of dollars to something. If you don't have much idea what your minimum spending on healthcare will be, just keep it as income for full freedom or use a different tax-advantaged option. It's just meant to be an option for people with good awareness of budgetting to save some money.

It works incredibly well for my family. We can put $3,200 in the FSA next year and not get taxed on it as well as spend the money tax free. You can buy cold medicine, advil, go to the dentist, go to the doctor, etc.

It’s not even necessarily by calendar year, as Breunig and many others find out the hard way.

I think the real use case for FSAs is people who have regular or predictable health care costs. If you know that, every month, you need $500 for insulin, or every year you have two $200 dentist visits that aren't covered by insurance, then paying those expenses with pre-tax money can be a big savings - saves federal tax, payroll tax, and state tax. If you're a young, healthy person whose biggest health expense is hangover advil, then FSA is not for you.

The vlogger's problem is he was putting money into the FSA "just in case," and got screwed because he didn't have need. I'm sure there are tons of HR departments out there that do a terrible job of explaining the use-it-or-lose-it nature of FSAs, so it's valuable to have the rant out there, but they are good accounts for the people that benefit.

A system designed to make ordinary people lose their own money for not following paperwork IS a scam.

What’s funny is that, if you’re rich enough to take advantage of it, the advantages that it provides are kinda small potatoes, especially considering the BS paperwork they require.