HSA Bills Advance Through the House

Last week, the House of Representatives passed two bills which would expand Health Savings Accounts and make other changes to the healthcare industry. 

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Published July 30, 2018

Below is a summary of key Health Savings Account (HSA) provisions included in each bill:

HR 6311

  • Medicare Part A would not eliminate HSA eligibility.
  • The maximum contribution limit would be increased to $6,650 per individual and $13,300 per family.
  • Both spouses age 55 and over could make catch-up contributions to the same HSA.
  • HSAs opened within 60 days of enrolling in a qualified high deductible health plan (HDHP) would be treated as being opened as the same day of enrollment in the HDHP (allowing expenses to be paid taxfree retroactive to the HDHP enrollment date).
  • Bronze and catastrophic plans would be considered HSA-eligible plans.

HR 6199

  • Coverage for non-preventive services up to $250 per individual and $500 per family could be provided prior to the deductible without disqualifying HSA eligibility.
  • HSA accountholders could receive care through a direct primary care (DPC) arrangement without disqualifying eligibility for an HSA, and DPC expenses could be paid tax -free from the HSA (up to $150/mo for an individual and $300/mo for a family).
  • On-site medical clinics made available by an employer would not disqualify HSA eligibility.
  • Coverage under a spouse’s Flexible Spending Account (FSA) would not disqualify HSA eligibility.
  • Conversions of funds from an FSA or HRA would be permitted into an HSA, up to certain limits, and only if an employer permitted the conversion.
  • Gym memberships, sports equipment and personal trainers would be qualified expenses , up to certain limits.
  • Removes the requirement to have a prescription for over-the counter drugs to be considered eligible expenses (applies to all reimbursement accounts).
  • Certain items related to menstrual care would be qualified expenses.

The next step is that these bills will move onto the Senate where 60 votes will be needed. This may be a difficult challenge. While most, if not all of the 51 Senate Republicans would likely vote in favor of these bills, Democratic leadership is likely to oppose the two bills. Many Democrats believe that expanding HSAs and other types of free market healthcare are an attack on the Affordable Car e Act (ACA). There’s also the upcoming midterm elections which may delay any swift action on these bills. At the same time, there was some bipartisan support from House members. Twelve Democrats voted to pass HR 6311 and 46 Democrats voted for HR 6199.