Unless you are 65 or older. Then you just pay normal income tax. I really wish I had started learning and participating in this stuff about 18 years ago. I would likely already be retired if I had been more responsible. But hey, I did have a lot of fun while being financially irresponsible.
Never really thought about taking it out because I use it. I guess if you contributed the max amount for 30+ years and paid out of pocket for your medical, you could accumulate a nice sum. There are still expenses with Medicare and the money can be used for insurance premiums so it seems better to keep it until you no longer need medical care. Who wants to be responsible when they are young? I always thought we should start out rich and die poor.
There is also an option to to invest the money in an HSA account tax free...though with our f'n turd of a president's economy I've been forced to go with the average down approach to investing to make it hurt less. Way to go "Tariff Man". I know the stock market isn't a good measurement for judging the health of the economy...but if President Hyperbole yells and takes credit for it when it's good, I'm sure as sh*t going to blame him for it when it's bad. Whoa, whoa...rant aborted.
I heard the reason was the FED, but then we tend to find a reason that supports our beliefs. You have a long investment horizon, sit tight, you will be fine.
I'm sure it is not just one thing. The crap coming out of the orange turd's mouth and his cabinet not having a clue what they are doing/talking about isn't helping any. These are just short term problems, this idiotic president won't be around forever.