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HSAs with tax savings pay off in retirement with caveats

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Health savings accounts could play a crucial and tax-advantaged role for clients’ medical costs in retirement, but holding them until age 65 and beyond poses some complexities as well.

The trifecta of pretax contributions, untaxed accumulation and duty-free withdrawals for qualified medical expenses in the accounts open to those with high-deductible health insurance may pay off extra in retirement — as long as financial advisors and their clients keep Medicare rules in mind and avoid a possible tax hit to non-spouse heirs in their estate plans, experts said. That’s because HSA withdrawals do not affect the calculation of taxes on Social Security benefits and aren’t subject to required minimum distributions like traditional individual retirement accounts.

READ MORE: These common HSA mistakes can cost clients 

Advisors and their clients can count on having plenty of uses for their HSAs: the average 65-year-old who retired last year could spend $165,000 on health care during retirement, according to Karen Volo, the head of health and benefit accounts at Fidelity Investments.

“Paying medical expenses in retirement should be a part of every planning conversation, given the burden of expense in retirement.  And there is no more advantageous way to prepare for those expenses than an HSA,” Volo said in an email. “Once you turn 65, you can use your HSA to pay for other nonqualified medical expenses, too. You’ll have to pay applicable state and federal taxes on these withdrawals, but this gives you another option for retirement income should you need it.”

The 20% penalty that would normally apply to the nonmedical use of the assets goes away once the client is over 65, noted Heather Schreiber, the founder of advanced planning consulting firm HLS Retirement Consulting. However, if the client decides to enroll in Medicare when they first reach eligibility at 65, they could risk paying a 6% excise tax for excess HSA contributions if they do not cut off the payments before joining Medicare, she said. 

On the other hand, they could also reap savings on the taxes for Social Security benefits by drawing from their HSAs for health expenses in retirement, due to the formula dictating those duties.

“HSAs are one of the few sources of income that don’t hit the provisional income calculations, so it’s a wonderful source,” Shreiber said. “Everyone’s concerned about the rising cost of health care and the potential for long-term care.”

READ MORE: Only 1 HSA provider rated ‘high’ quality by Morningstar. Here’s why

She and Volo each described clients’ immediate healthcare needs prior to retirement as the key challenge confronting their efforts to set aside their HSAs until retirement. Ideally, each client would contribute as much as possible “up to the yearly maximum to harness the power of compounding with your tax-free HSA dollars,” Volo said.  

“You can always leave a portion of your HSA balance in cash to pay for qualified medical expenses as they arise if you need to,” she said. “On the other hand, it’s not a bad idea to pay for medical expenses with your regular savings if you are able to; just be sure to save the receipts! Much like the account itself, ‘qualified medical expenses’ never expire, either. If you pay for a qualified medical expense out-of-pocket, you can submit saved receipts for reimbursement at any point. Whether it’s two, 12 or 20 years in the future, you can pay yourself back with the tax-free dollars you’ve compounded in your HSA.”

The “tricky” questions surrounding how best to use HSAs in retirement means that advisors should guide clients carefully on the timing of their Medicare enrollment and when to begin collecting their Social Security benefits, Schreiber said. The current standard expenses of more than $2,700 per year for Medicare Part B and D premiums could prove a helpful topic to raise with the clients, alongside the pronounced rate of inflation for health care costs.

“They’re roughly triple what normal inflation is,” she said. “Think about those expenses that you could cover using a health savings account.”

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Accounting

IAASB tweaks standards on working with outside experts

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The International Auditing and Assurance Standards Board is proposing to tailor some of its standards to align with recent additions to the International Ethics Standards Board for Accountants’ International Code of Ethics for Professional Accountants when it comes to using the work of an external expert.

The proposed narrow-scope amendments involve minor changes to several IAASB standards:

  • ISA 620, Using the Work of an Auditor’s Expert;
  • ISRE 2400 (Revised), Engagements to Review Historical Financial Statements;
  • ISAE 3000 (Revised), Assurance Engagements Other than Audits or Reviews of Historical Financial Information;
  • ISRS 4400 (Revised), Agreed-upon Procedures Engagements.

The IAASB is asking for comments via a digital response template that can be found on the IAASB website by July 24, 2025.

In December 2023, the IESBA approved an exposure draft for proposed revisions to the IESBA’s Code of Ethics related to using the work of an external expert. The proposals included three new sections to the Code of Ethics, including provisions for professional accountants in public practice; professional accountants in business and sustainability assurance practitioners. The IESBA approved the provisions on using the work of an external expert at its December 2024 meeting, establishing an ethical framework to guide accountants and sustainability assurance practitioners in evaluating whether an external expert has the necessary competence, capabilities and objectivity to use their work, as well as provisions on applying the Ethics Code’s conceptual framework when using the work of an outside expert.  

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Accounting

Tariffs will hit low-income Americans harder than richest, report says

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President Donald Trump’s tariffs would effectively cause a tax increase for low-income families that is more than three times higher than what wealthier Americans would pay, according to an analysis from the Institute on Taxation and Economic Policy.

The report from the progressive think tank outlined the outcomes for Americans of all backgrounds if the tariffs currently in effect remain in place next year. Those making $28,600 or less would have to spend 6.2% more of their income due to higher prices, while the richest Americans with income of at least $914,900 are expected to spend 1.7% more. Middle-income families making between $55,100 and $94,100 would pay 5% more of their earnings. 

Trump has imposed the steepest U.S. duties in more than a century, including a 145% tariff on many products from China, a 25% rate on most imports from Canada and Mexico, duties on some sectors such as steel and aluminum and a baseline 10% tariff on the rest of the country’s trading partners. He suspended higher, customized tariffs on most countries for 90 days.

Economists have warned that costs from tariff increases would ultimately be passed on to U.S. consumers. And while prices will rise for everyone, lower-income families are expected to lose a larger portion of their budgets because they tend to spend more of their earnings on goods, including food and other necessities, compared to wealthier individuals.

Food prices could rise by 2.6% in the short run due to tariffs, according to an estimate from the Yale Budget Lab. Among all goods impacted, consumers are expected to face the steepest price hikes for clothing at 64%, the report showed. 

The Yale Budget Lab projected that the tariffs would result in a loss of $4,700 a year on average for American households.

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Accounting

At Schellman, AI reshapes a firm’s staffing needs

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Artificial intelligence is just getting started in the accounting world, but it is already helping firms like technology specialist Schellman do more things with fewer people, allowing the firm to scale back hiring and reduce headcount in certain areas through natural attrition. 

Schellman CEO Avani Desai said there have definitely been some shifts in headcount at the Top 100 Firm, though she stressed it was nothing dramatic, as it mostly reflects natural attrition combined with being more selective with hiring. She said the firm has already made an internal decision to not reduce headcount in force, as that just indicates they didn’t hire properly the first time. 

“It hasn’t been about reducing roles but evolving how we do work, so there wasn’t one specific date where we ‘started’ the reduction. It’s been more case by case. We’ve held back on refilling certain roles when we saw opportunities to streamline, especially with the use of new technologies like AI,” she said. 

One area where the firm has found such opportunities has been in the testing of certain cybersecurity controls, particularly within the SOC framework. The firm examined all the controls it tests on the service side and asked which ones require human judgment or deep expertise. The answer was a lot of them. But for the ones that don’t, AI algorithms have been able to significantly lighten the load. 

“[If] we don’t refill a role, it’s because the need actually has changed, or the process has improved so significantly [that] the workload is lighter or shared across the smarter system. So that’s what’s happening,” said Desai. 

Outside of client services like SOC control testing and reporting, the firm has found efficiencies in administrative functions as well as certain internal operational processes. On the latter point, Desai noted that Schellman’s engineers, including the chief information officer, have been using AI to help develop code, which means they’re not relying as much on outside expertise on the internal service delivery side of things. There are still people in the development process, but their roles are changing: They’re writing less code, and doing more reviewing of code before it gets pushed into production, saving time and creating efficiencies. 

“The best way for me to say this is, to us, this has been intentional. We paused hiring in a few areas where we saw overlaps, where technology was really working,” said Desai.

However, even in an age awash with AI, Schellman acknowledges there are certain jobs that need a human, at least for now. For example, the firm does assessments for the FedRAMP program, which is needed for cloud service providers to contract with certain government agencies. These assessments, even in the most stable of times, can be long and complex engagements, to say nothing of the less predictable nature of the current government. As such, it does not make as much sense to reduce human staff in this area. 

“The way it is right now for us to do FedRAMP engagements, it’s a very manual process. There’s a lot of back and forth between us and a third party, the government, and we don’t see a lot of overall application or technology help… We’re in the federal space and you can imagine, [with] what’s going on right now, there’s a big changing market condition for clients and their pricing pressure,” said Desai. 

As Schellman reduces staff levels in some places, it is increasing them in others. Desai said the firm is actively hiring in certain areas. In particular, it’s adding staff in technical cybersecurity (e.g., penetration testers), the aforementioned FedRAMP engagements, AI assessment (in line with recently becoming an ISO 42001 certification body) and in some client-facing roles like marketing and sales. 

“So, to me, this isn’t about doing more with less … It’s about doing more of the right things with the right people,” said Desai. 

While these moves have resulted in savings, she said that was never really the point, so whatever the firm has saved from staffing efficiencies it has reinvested in its tech stack to build its service line further. When asked for an example, she said the firm would like to focus more on penetration testing by building a SaaS tool for it. While Schellman has a proof of concept developed, she noted it would take a lot of money and time to deploy a full solution — both of which the firm now has more of because of its efficiency moves. 

“What is the ‘why’ behind these decisions? The ‘why’ for us isn’t what I think you traditionally see, which is ‘We need to get profitability high. We need to have less people do more things.’ That’s not what it is like,” said Desai. “I want to be able to focus on quality. And the only way I think I can focus on quality is if my people are not focusing on things that don’t matter … I feel like I’m in a much better place because the smart people that I’ve hired are working on the riskiest and most complicated things.”

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