16 Bills to Expand Flexibility of Health Savings Accounts #HSA #HSAs

Thank you to Kim Corba, DO for compiling this list of bills under consideration in Congress intended to increase the flexibility of Health Savings Accounts.

H.R.3565 — 116th Congress (2019-2020) Veterans Health Savings Account Act Sponsor: Rep. Gosar, Paul A. [R-AZ-4] (Introduced 06/27/2019) Cosponsors: (7) Committees: House – Ways and Means Latest Action: House – 06/27/2019 Referred to the House Committee on Ways and Means.

This billallows veterans who receive hospital care or medical servicesunder any law administered by the Department of Veterans Affairs to remaineligible to participate in or contribute to a health savings account.

H.R.2177 — 116th Congress (2019-2020) Faith in Health Savings Accounts Act of 2019 Sponsor: Rep. Kelly, Mike [R-PA-16] (Introduced 04/09/2019) Cosponsors: (23) Committees: House – Ways and Means Latest Action: House – 04/09/2019 Referred to the House Committee on Ways and Means.

This billmodifies the requirements for health savings accounts (HSAs) to treat membership in atax-exempt health care sharing ministry as coverage under a high deductible health plan forpurposes of the tax deduction for contributions to an HSA.

H.R.603 — 116th Congress (2019-2020) Health Savings AccountExpansion Act of 2019 Sponsor: Rep. Gallagher, Mike [R-WI-8] (Introduced 01/16/2019) Cosponsors: (14) Committees: House – Ways and Means Latest Action: House – 03/01/2019Referred to the Subcommittee on Health.

This bill modifies the requirementsfor health savings accounts (HSAs) to:

  • increasethe maximum contribution amounts,
  • permitthe use of HSAs to pay health insurance premiums and for directprimary care service arrangements,
  • repealthe restriction on using HSAs for over-the-counter medications,
  • eliminatethe requirement that a participant in an HSA be enrolled in a highdeductible health care plan, and
  • decreasethe additional tax for HSA distributions not used for qualified medicalexpenses.


H.R.457 — 116th Congress (2019-2020) Health Savings Account Act Sponsor: Rep. Fortenberry, Jeff [R-NE-1] (Introduced 01/10/2019) Cosponsors: (0) Committees: House – Ways and Means Latest Action: House – 01/10/2019 Referred to the Subcommitteeon Health.

This bill modifies the requirementsfor health savings accounts (HSAs) to (1) increasethe maximum contribution limits for HSAs to match the sum of the annualdeductible and out-of-pocket expenses permitted under a highdeductible health plan, (2) allow individualswho receive primary care services in exchange for a fixed periodic fee orpayment to participate in an HSA, and (3) permit HSAs to beused for fitness center memberships.

The bill also allows a medical caretax deduction for periodic provider fees, including (1) periodicfees paid to a primary care physician for a defined set of medical services or theright to receive medical services on an as-needed basis; and (2) pre-paidprimary care services designed to screen for, diagnose, cure, mitigate, treat,or prevent disease and promote wellness.


S.2440 — 116th Congress (2019-2020) Qualified Health Savings AccountDistribution Act of 2019 Sponsor: Sen. Sasse, Ben [R-NE] (Introduced 08/01/2019) Cosponsors: (0) Committees: Senate – Finance Latest Action: Senate – 08/01/2019 Read twice and referred to the Committeeon Finance.

Official text still being written.  Quick summary—this bill proposes funds can be moved from FSAs and HRAs into HSAs

S.2441 — 116th Congress (2019-2020) Health Savings Account Expansion Actof 2019 Sponsor: Sen. Sasse, Ben [R-NE] (Introduced 08/01/2019) Cosponsors: (0) Committees: Senate – Finance Latest Action: Senate – 08/01/2019 Read twice and referred to the Committeeon Finance.

Allow individuals who are not enrolled in a highdeductible health planto have access to health savings accounts

H.R.4576 — 116th Congress (2019-2020)To amend the InternalRevenue Code of 1986 to allow contributionsto health savings accounts in the case of individuals withspouses who have health flexible spending accounts. Sponsor: Rep. Wexton, Jennifer [D-VA-10] (Introduced09/27/2019) Cosponsors: (2) Committees: House – Ways andMeans LatestAction: House – 09/27/2019 Referred to the House Committee on Waysand Means.

As of09/30/2019 text has not been received for H.R.4576 – To amend theInternal Revenue Code of 1986 to allow contributions to health savings accounts in the case of individuals with spouses whohave health flexiblespending accounts.

H.R.4530 — 116th Congress (2019-2020) To amend the InternalRevenue Code of 1986 to permit individuals eligible forIndian Health Service assistance to qualifyfor health savings accounts. Sponsor: Rep. Moolenaar, John R. [R-MI-4] (Introduced09/26/2019) Cosponsors: (1) Committees: House – Ways andMeans LatestAction: House – 09/26/2019 Referred to the House Committee on Waysand Means.

As of09/30/2019 text has not been received for H.R.4530 – To amend the InternalRevenue Code of 1986 to permit individuals eligible for Indian Health Service assistance to qualify for health savings accounts.


S.12 — 116th Congress (2019-2020) Health Savings Actof 2019 Sponsor: Sen. Rubio, Marco [R-FL] (Introduced 01/03/2019) Cosponsors: (1)Committees: Senate – Finance Latest Action: Senate – 01/03/2019 Readtwice and referred to the Committee on Finance.

This bill modifies the requirementsfor health savings accounts (HSAs) to

  • rename highdeductible health plans as HSA-qualified health plans;
  • allow spouses who haveboth attained age 55 to make catch-up contributions to the same HSA;
  • make Medicare Part A(hospital insurance benefits) beneficiaries eligible to participate in an HSA;
  • allow individuals eligiblefor hospital care or medical services under a program of theIndian Health Service or a tribal organization to participate in anHSA;
  • allow members ofa health care sharing ministry to participate in an HSA;
  • allowindividuals who receive primary care services in exchange for a fixed periodicfee or payment, or who receive health care benefits from an onsitemedical clinic of an employer, to participate in an HSA;
  • include amounts paid forprescription and over-the-counter medicines or drugs as “qualified medicalexpenses” for which distributions from an HSA or othertax-preferred savings accounts may be used;
  • increase the limits on HSAcontributions to match the sum of the annual deductible and out-of-pocketexpenses permitted under a high deductible health plan; and
  • allow HSA distributions tobe used to purchase health insurance coverage.

The bill also: (1) exempts HSAs from creditor claims in bankruptcy,and (2) reauthorizes Medicaid health opportunity accounts.

The bill allows a medical care tax deduction for: (1) exerciseequipment, physical fitness programs, and membership at a fitness facility; (2)nutritional and dietary supplements; and (3) periodic fees paid to a primarycare physician and amounts paid for pre-paid primary care services.

 H.R.3796 — 116th Congress (2019-2020) Health Savings for Seniors Act Sponsor: Rep. Bera, Ami [D-CA-7] (Introduced 07/17/2019) Cosponsors: (1)Committees: House – Ways and Means Latest Action: House – 07/17/2019 Referred to the House Committee on Waysand Means.

This bill permits a Medicare beneficiary to participate in andcontribute to health savings accounts.

H.R.2878 — 116th Congress (2019-2020) Homecare for Seniors Act Sponsor: Rep. Porter, Katie [D-CA-45] (Introduced 05/21/2019) Cosponsors: (10) Committees: House – Ways and Means Latest Action: House – 05/21/2019Referred to the House Committee on Ways and Means

This bill allow tax-exempt distributions from health savings accounts (HSAs)to be used for qualified home care.

“Qualified home care” includes a contract to provide threeor more of the following services in the residence of the service recipient

  • assistance with eating,
  • assistance with toileting,
  • assistance withtransferring,
  • assistance with bathing,
  • assistance with dressing,
  • assistance withcontinence, and
  • medication adherence.

The Department of Health and Human Services must carry outa campaign to increase public awareness of the in-home service expenses thatare eligible for tax-free distribution from HSAs.

 S.1089 — 116th Congress (2019-2020) Restoring Access to Medication Act of 2019 Sponsor: Sen. Roberts, Pat [R-KS] (Introduced 04/09/2019) Cosponsors: (3)Committees: Senate – Finance Latest Action: Senate – 04/09/2019 Read twice and referred to the Committeeon Finance.

This billrepeals provisions of the Internal Revenue Code, as added by the PatientProtection and Affordable Care Act, that limit payments for medicationsfrom health savings accounts, medical savings accounts, and health flexible spending arrangements to only prescription drugs orinsulin (thus allowing distributions from such accounts for over-the-counterdrugs).

H.R.908 — 116th Congress (2019-2020) Stop Penalizing Working Seniors Act Sponsor: Rep. Latta, Robert E. [R-OH-5] (Introduced 01/30/2019) Cosponsors: (5)Committees: House – Ways and Means Latest Action: House – 01/30/2019 Referred to the House Committee on Waysand Means.

This bill allows Medicare-eligible individuals who are age 65 or olderto contribute to health savings accounts iftheir entitlement to Medicare benefits is limited to hospital insurancebenefits under Medicare Part A.

H.R.3708 — 116th Congress (2019-2020)Primary Care Enhancement Act of 2019Sponsor: Rep. Blumenauer, Earl [D-OR-3] (Introduced 07/11/2019) Cosponsors: (5)Committees: House – Ways and MeansLatest Action: House – 07/11/2019 Referred to the House Committee on Ways and Means.

This bill permits a taxpayer with a primary care service arrangement whose fixed periodic fee does not exceed $150 a month to participate in and contribute to a health savings account. Read about flaws in H.R. 3708 at https://dpcaction.com/take-action-dpc-action-statement-opposing-hr-3708/

H.R.2163 — 116th Congress (2019-2020) Freedom for Families Act Sponsor: Rep. Biggs, Andy [R-AZ-5] (Introduced 04/09/2019) Cosponsors: (20) Committees: House – Ways and Means Latest Action: House – 04/09/2019 Referred to the House Committee on Waysand Means

To amend the Internal Revenue Code of 1986 to allow fortax-advantaged distributionsfrom health savings accounts during family or medicalleave, and for other purposes.

 H.R.3594 — 116th Congress (2019-2020) Healthcare Freedom Act of 2019 Sponsor: Rep. Roy, Chip [R-TX-21] (Introduced 06/28/2019) Cosponsors: (10) Committees: House – Ways and Means Latest Action: House – 06/28/2019 Referred to the House Committee on Waysand Means. 

This bill expands the availabilityof health savings accounts. It renamessuch accounts as “health freedom accounts” andallows all individuals to receive increased tax deductions for contributions tosuch accounts. The term “qualified medical expenses” is expanded toinclude costs associated with direct primary care, health caresharing ministries, and medical cost sharing organizations.

The bill also excludes employercontributions to health freedom accounts from employeegross income for income tax purposes.

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