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Americans need more exercise—and should be able to tap FSA and HSA funds to pay for gyms, studios, and sports leagues

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Americans need more exercise—and should be able to tap FSA and HSA funds to pay for gyms, studios, and sports leagues

Exercise matters. In the battle against America’s rising tide of overweight and obese youth, increasing mental health concerns, and growing threat of chronic disease prevalence, the simplest prescription is movement—every step, every workout, every sport and physical activity improves physical and mental health. 

What’s more, the ramifications of childhood obesity are profound, ranging from cardiovascular issues to heightened diabetes risk, as highlighted by the Government Accountability Office. With health care costs rising and cultural influences promoting sedentary lifestyles, the imperative to act has never been more urgent.

The future of our country is inextricably tied to our ability to move, and it is necessary for all of us—lawmakers, parents, educators, small business owners, employers—to embrace and support physical activity as a necessary component of health care. 

The Health & Fitness Association, a trade group I lead, is this week releasing new data illustrating the economic powerhouse the health and fitness industry has become—and the vital role it plays in our economy. This first-of-its kind data demonstrates why the industry deserves a seat at the table, alongside government and health care leaders, as we continue to advance toward preventive—not prescriptive—care. 

The data reveals that local health and fitness establishments collectively employ over 430,000 workers across 55,000 locations, injecting over $22 billion directly into our local and national economy while also strengthening the American middle class. Furthermore, the Health and Fitness Association also reports that across the nation some 70 million consumers regularly use industry facilitieshealth and fitness clubs, gyms, studios, sports and aquatic facilities, camps, and industry partners. 

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Empowering busy parents, educators, and students to embrace this ethos requires innovative solutions. One such solution lies in extending financial support for physical activity and equipment through flexible and health spending accounts (FSAs and HSAs), mirroring the approach taken with numerous other consumer health products.

Flexible Spending Accounts (FSAs) and Health Savings Accounts (HSAs) are tools for managing health care expenses, but they differ from traditional ones. FSAs, provided by employers, allow pre-tax contributions, but funds expire at year-end, with any remaining balance reverting to the employer. HSAs, for those with high-deductible health plans, offer tax-deductible contributions, potential growth, and rollover funds, providing flexibility and long-term savings potential.

We’re collaborating with national leaders to champion bipartisan legislation called the Personal Health Investment Today (PHIT) Act, aimed at expanding families’ access to all manner of physical activity programs and equipment, for both youth and adults alike. Under it, FSAs and HSAs could be used to pay for health club memberships, fitness equipment, exercise videos, and youth sports leagues. If passed, it would enable individuals to use up to $1,000 per year—up to $2,000 for families—to cover physical activity-related expenses.

The proposed legislation extends coverage to these expenses for employees, aligning with the model through which millions of Americans already purchase over-the-counter health products, such as cold and pain relievers. By streamlining access to these resources, we can combat the troubling statistics outlined by the Centers for Disease Control, where only a fraction of children meet the recommended levels of daily exercise and rates of obesity continue to soar, especially among communities of color.

Harnessing FSAs and HSAs for exercise initiatives is a logical extension of existing practices, given that these accounts already support a myriad of health-related services and products. Physical activity stands as a universally accessible tool for enhancing both physical and mental well-being, making its inclusion in these programs not only sensible but essential.

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Additionally, expanding eligibility to encompass youth sports programs and fitness courses for adults, as proposed by the PHIT Act, makes good financial sense because millions of Americans who use FSA and HSA benefit accounts leave leftover funds in the accounts at the end of the year—funds that most consumers do not know revert to their employer.

Beyond the realms of family and youth fitness, such measures hold the potential to address broader societal challenges, including military readiness, where obesity rates have hindered recruitment in recent years.

The federal government already recognizes the importance of using federal policy and support to encourage and empower consumers to take action.

This year will be the first time physical activity expenses are eligible as qualified expenses for many HSAs when prescribed for medical necessity. This new tax treatment is a great first step for empowering employees to leverage their funds in order to combat a critical health care challenge in our society. Now is the time to fully embrace physical activity and take the investment in our country’s overall well-being to the next level. We know it can be done. 

Expanding access to fitness programs through taxpayer-funded initiatives represents a commonsense approach whose time is overdue. 

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Every week, some 70 million consumers from ages 8 to 80 visit more than 55,000 different types of gyms, studios, and other fitness facilities because they know and experience the physical and mental health benefits of exercise. Federal policy should help expand access and encourage good habits like these—it would benefit all of us in the long run.

Let’s seize this opportunity to empower individuals of all ages to embrace a lifestyle of movement, vitality, and well-being. The future of our country—and our economic lives—depends on our ability to take bold action and embrace a sensible, scientific approach to empowering a population that is healthy, able to face today’s obstacles, and prepared for the tomorrow’s challenges.  

Liz Clark is president and CEO of the Health & Fitness Association, a trade group representing health and fitness facilities, along with their partners and suppliers. She’s the first woman to head the organization in its 40-year history.

More must-read commentary:

The opinions expressed in Fortune.com commentary pieces are solely the views of their authors and do not necessarily reflect the opinions and beliefs of Fortune.

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Fitness

Very difficult and extremely cool: how to start doing pull-ups

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Very difficult and extremely cool: how to start doing pull-ups

The pull-up has long been seen as an important fitness metric. From 1966 to 2013, public middle and high school students in the US were required to do pull-ups as part of the presidential fitness test (an evaluation Donald Trump has considered reinstating). US Marine Corps members were long required to perform pull-ups as part of their regular physical fitness test, and prospective UK Royal Marines must complete a minimum of three to four pull-ups before they are eligible to join.

There is no definitive data on how many adults can perform a proper pull-up, but two things are clear: they are very difficult and look extremely cool.

“When a new client comes to see me, the most common exercise they say they’d like to be able to do is the pull-up,” says Emily Schofield, a certified personal trainer at the training company Ultimate Performance. “Achieving that first proper rep is one of the most satisfying milestones you can reach in the gym, because it’s a genuine, hard-earned display of strength, coordination and control.”

Do you want to literally and figuratively flex on others at the gym? Here’s how to start doing pull-ups.

What is a pull-up?

To perform a pull-up, a person starts by hanging from a bar with their arms fully extended and feet off the ground; this is also known as a dead hang. From there, they pull themselves up until their chin is over the bar, and then lower with control.

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“Done well, it’s a controlled, deliberate movement,” says Schofield. “There’s no kicking, jerking or relying on momentum.”

What are the benefits of pull-ups?

Pull-ups build upper body strength, particularly in the back, says Mathew Forzaglia, certified personal trainer and founder of Forzag Fitness. “It also helps develop core stability, which prevents the body from swaying during consecutive reps, and improves grip strength,” he says.

The muscles most engaged by the exercise, according to the Cleveland Clinic, are the latissimus dorsi (or “lats”) – the large, broad, fan-shaped muscles which stretch from the bottom of the back to below the shoulder blades – and the trapezius (or “traps”) – the triangle-shaped muscles that run from the neck to the mid-back. They also engage shoulders, forearms, biceps, triceps and abdominal muscles.

When Schofield performs a pull-up, she says she focuses on not just using her arms: “Putting too much emphasis on your biceps to execute the move will make you tire quickly and diminish how effectively you’re targeting the lower back,” she explains, adding that the lats should be doing the heavy lifting.

In addition to looking impressive at the gym, pull-ups also help with functional strength. Because pull-ups force the body to work as a single unit, they improve “strength, coordination and neuromuscular control”, as well as helping with posture, improved performance on other lifts, and a more balanced physique overall, Schofield says.

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Can anyone do a pull-up?

For the most part, yes.

Many women in particular seem to doubt this. And can you blame them, when the New York Times once published an article titled, Why Women Can’t Do Pull-Ups? (Granted, the article was controversial at the time, and several outlets and blogs published rebuttals.)

Schofield says many women she works with “instantly dismiss the idea they’ll ever be strong enough to perform a pull-up”. But she emphasizes that neither age nor gender should be considered a barrier to the exercise.

“I train a client who is in her 70s and she can perform a full set of eight pull-ups with greater strength and control than people half her age,” Schofield says.

Some people need to be especially careful when performing pull-ups, Schofield says – specifically those with shoulder injuries, elbow painor any type of upper-body joint issue.

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“In those cases, I’d always prioritize rehab and strengthening work before attempting the exercise,” she says.

How do you do a pull-up?

One of the most common mistakes people make when it comes to pull-ups is jumping straight on to the bar, Schofield says. Most people will need to build up a base of strength before they can successfully perform the exercise.

To do this, prioritize exercises that strengthen the muscles you will need to perform a pull up. These include:

Forzaglia also recommends inverted rows using TRX straps or a barbell set up in a squat rack. “This helps build the foundational pulling strength needed to progress,” he says.

Even if you can’t complete a pull-up, it’s worth spending time on the bar, Schofield says: “That might mean attempting partial reps, holding the top position, or controlling the lowering phase.” All of these help the body learn how to coordinate the movement, she explains.

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Regardless of gender, building to a full pull-up can be a slow process. Countless programs claim to be able to teach people how to do a pull-up in 30 days. That might be possible for some. But achieving a pull-up depends on a number of factors, including baseline fitness, bodyweight and physical build. Although the above exercises are all relatively safe, it is a good idea to work with a certified personal trainer who can offer the best personalized guidance. And encouragement.

“Because pull-ups are difficult, people tend to avoid them when they struggle. But that’s exactly when they should practice them the most,” Schofield says. “The key is to practice, practice, practice.”

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Strengthen your lower abs with this unusual but beginner-friendly core exercise

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Strengthen your lower abs with this unusual but beginner-friendly core exercise

We’re always on the lookout for new core exercises to add to our fitness routines, especially ones that help improve form and control. Midlife trainer Dr Won Dolegowski created the barbell back-supported knee raise with exactly this in mind, saying the movement ‘trains your lower abs without stressing your lower back’ while also teaching core control by reducing momentum and swinging.

‘A strong core goes beyond aesthetics. You need it for better posture, to protect your back and to carry you through life,’ she says.

Sarah Campus, PT, instructor, nutrition coach and founder of LDN MUMS FITNESS, explains how to perform the exercise with proper form, why it’s so effective and the key muscles it works.


How to do the barbell back-supported knee raise

  • Set up a barbell on a rack so it sits at lower-back height when you’re positioned beneath it. Add a hip-thrust pad for comfort.
  • Lean your lower back against the bar for support and stability, keeping your core engaged throughout.
  • Raise your knees towards your chest by curling your pelvis upwards, rather than simply lifting your legs.
  • Slowly lower your legs back down with control, avoiding swinging or arching through the lower back.

Muscles worked

The movement mainly targets the core muscles, says Campus, including:

  • Rectus abdominis – particularly during the lifting phase of the knee raise
  • Hip flexors – which help lift the knees
  • Obliques – which assist with stability and pelvic control
  • Transverse abdominals – for deep core stabilisation

Other muscles involved include:

  • Quadriceps – which help maintain leg position
  • Forearm and grip muscles – which help support your hold on the bar
  • Shoulders and upper back – which stabilise the torso against the support

Benefits of the barbell back-supported knee raise

Campus says the exercise offers several key benefits:

  • The core stays under constant tension throughout the movement, as the back support reduces momentum and swinging.
  • It helps stabilise the spine and pelvis, reducing strain on the lower back and making the exercise feel safer and more comfortable.
  • Because the torso stays in a fixed position, it’s easier to perform a proper pelvic curl at the top of the movement, helping improve lower-ab engagement and control.
  • It can also help strengthen grip, adds Dolegowski.

Modifications of the barbell back-supported knee raise

1. Reverse crunches

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  • Lie on your back with your legs extended and arms by your sides, palms facing down. For extra support, place your hands underneath your hips.
  • Press your lower back into the floor and brace your core by pulling your belly button towards your spine.
  • Engage your lower abs to lift your legs and curl your knees towards your chest, allowing your hips to lift slightly off the floor at the top of the movement.
  • Slowly lower your hips back down with control before extending your legs back to the starting position.

2. Hanging knee raises

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  • Hang from a bar with your hands slightly wider than shoulder-width apart. Pull your shoulder blades down and brace your core.
  • Bend your knees and raise them towards your chest using your core muscles, aiming to bring them up to hip height without swinging.
  • Pause briefly at the top of the movement while keeping your torso stable.
  • Slowly lower your legs back to the starting position with control.

3. Captain’s chair leg raises

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  • Position yourself in a captain’s chair with your back against the support pad and your forearms resting on the arm pads. Let your legs hang straight down.
  • Brace your core and slowly raise your straight legs until they reach hip height or slightly higher.
  • Pause briefly at the top while keeping your torso steady and avoiding swinging.
  • Lower your legs back down slowly and with control before repeating.

Having a strong core is about far more than sporting a six-pack. Build functional mid-section strength – while also improving your power, posture, coordination and balance – with WH COLLECTIVE coach Izy George’s 4-week core challenge. Download the Women’s Health UK app to access the full training plan today.

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Sarah Campus is a highly qualified women’s PT, Nutrition Coach, Running Coach, Distance Runner, mum of 3 and founder of LDN MUMS FITNESS.

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She’s the host of the Soho House Run Club in Chiswick and a STRAVA and TOMMY’s marathon coach and ambassador. She specialises helping non-runners get into competitive distance running.

As a fitness and holistic wellness expert, Sarah regularly features on TV and in Magazines, offering tips and advice to keep the whole family healthy and active.

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What is Americans’ favorite exercise? New study reveals a surprising trend in fitness habits

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What is Americans’ favorite exercise? New study reveals a surprising trend in fitness habits
Walking is often treated as the simplest, most sustainable way to stay active and for good reason. It requires no equipment, no gym membership, and it fits easily into daily life. But a large new analysis suggests that while walking is extremely popular, it may not be enough on its own for most people to meet widely recommended fitness benchmarks.

A study published in the open-access journal PLOS ONE analyzed data from the Centers for Disease Control and Prevention Behavioral Risk Factor Surveillance System, drawing on survey responses from almost 400,000 U.S. adults. The objective was to know which leisure-time physical activities people prefer and whether those options align with federal activity guidelines.

Walking is most popular but not the most effective for fitness goals

The results were notable. Walking appeared as the most frequently reported leisure-time physical activity across both urban and rural groups. In fact, roughly 44.1% of adults indicated that walking was their main form of exercise.

However, popularity did not translate into achieving recommended health standards. Based on the analysis, individuals who primarily walked had the highest likelihood of not meeting either aerobic or muscle-strengthening guidelines compared with other exercise categories. Even more significant, only about one in four walkers (25%) satisfied both recommended benchmarks, while approximately 22% failed to meet either requirement at all. In contrast, participants who reported running, resistance training, or conditioning workouts as their primary activities were considerably more likely to achieve federal physical activity targets.

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What the guidelines actually require

The American College of Sports Medicine recommends that adults get:

  • At least 150 minutes per week of moderate-intensity aerobic activity
  • Plus muscle-strengthening exercises on two to three days per week

While walking can contribute to aerobic activity mainly if done briskly, it generally does not fulfill the strength-training requirement on its own.

Rural vs urban differences in activity patterns

The study also revealed geographic variations in exercise behavior. Rural residents were more likely to participate in activities such as gardening, hunting, and fishing, whereas urban residents showed higher engagement in running, cycling, dancing, and weight training. Despite differing preferences, urban participants were overall more likely to meet both aerobic and strength-based guidelines compared to rural populations. Researchers suggest that access to facilities, infrastructure availability, and cultural influences may contribute to these differences.

Why this matters: muscle is a key part of health

A key takeaway from the study is that physical activity guidelines are not just about movement, but about different types of movement. Walking supports cardiovascular fitness and daily activity levels, but it does not significantly develop or preserve muscle mass. This distinction is important because muscle deterioration begins gradually with age. Research indicates that adults may lose around 3% to 8% of muscle mass per decade after age 30, a condition known as sarcopenia. This decline is associated with slower metabolism, increased fat storage, reduced mobility, and higher risk of falls and fractures in later life.

Resistance training helps counteract this decline. Studies show it can increase lean muscle mass, boost resting metabolic rate by approximately 7%, and reduce body fat. A large meta-analysis also found resistance training linked to:

  • 15% lower risk of all-cause mortality
  • 19% lower cardiovascular disease mortality
  • 14% lower cancer mortality

The most notable benefits were observed with around 60 minutes per week of resistance exercise, making it a time-efficient health strategy. Additionally, resistance training supports mental well-being by improving mood and increasing BDNF (brain-derived neurotrophic factor), which promotes brain health and neural growth.

What truly makes the difference

The study aligns with broader longevity research suggesting that higher-effort activities tend to deliver stronger physiological benefits.

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Running, weight training, and conditioning workouts share a common feature: they sufficiently challenge the body to trigger adaptation. Walking, although beneficial, generally remains in a lower-intensity range that may not fully satisfy all fitness requirements on its own.

In practical terms:

  • Walking supports general cardiovascular health, mental well-being, and daily movement
  • Resistance training builds and preserves muscle, supports metabolism, and reduces age-related decline
  • Higher-intensity cardio (running, cycling, HIIT) improves cardiovascular fitness more efficiently and helps meet aerobic goals faster

Expert perspective from the study

The researchers emphasized that the findings are not meant to discourage walking but to emphasize gaps between perception and results.

As lead researcher Christiaan Abildso explained:

“We expected to see that walking would continue to be the most common physical activity. However, it was surprising to see that nearly one in four adults who walk as their main activity did not meet either of the physical activity guidelines. That is, they reported less than the recommended 150 minutes per week of moderate-intensity aerobic activity and fewer than the recommended two days per week of muscle-strengthening activity, such as yoga or exercises with resistance bands,”

He also pointed to wider environmental and structural elements influencing activity levels:

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“What we might be seeing in these rural–urban differences in preferences may just reflect what people have access to or what is culturally supported. In our work, we see a need to continue to support our partners in small towns and rural places by creating physical, social, and cultural conditions that support physical activity. This could mean creating a wide shoulder on a country road for running and cycling, helping a senior centre with their chair exercise programming, creating or improving park spaces, expanding the national network of rail trails, renovating abandoned and dilapidated structures (brownfields) into viable activity centres, keeping school facilities open to the public, and many other strategies. Everyone needs to ask, ‘how does what we’re doing affect physical activity?’, in order to help get people more active, more often, in more places,”

FAQs:

1. Is walking good for health?
Yes, walking supports heart health and general well-being. It is a low-impact activity suitable for most people.

2. Can walking replace all exercise?
Not entirely, because it does not build muscle strength effectively. A balanced routine usually includes strength training.

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