Two HSA-Related Bills Passed by House, Senate Prospects Uncertain

The House of Representatives passed two bills that would make changes to health savings accounts (HSAs), Archer medical savings accounts (MSAs), flexible spending accounts (FSAs), and health reimbursement arrangements (HRAs). There currently is no timetable for their being taken up by the Senate, nor certainty that they will be, during the 2018 session. HSAs are increasingly high profile savings vehicles, given the significant shift toward high-deductible health plans (HDHPs) as an employer health care benefit.

H.R. 6199

H.R. 6199, Restoring Access to Medication and Modernizing Health Savings Accounts Act of 2018, would do the following.

  • Allow HSA-eligible health plans to provide first-dollar coverage (coverage prior to satisfying a deductible) of a non-preventive nature in amounts up to $250 for those with individual coverage, $500 for those with family coverage
  • Allow treatment at an on-site employer or retail (e.g., pharmacy) clinic without the recipient being considered covered by an HSA-disqualifying health plan
  • HSA contribution eligibility under specified circumstances would not be affected by a spouse who is covered by a health FSA
  • A newly-established HSA could receive amounts transferred from a health FSA or HRA in an amount not to exceed the maximum annual FSA contribution limit ($2,650 for an individual and $5,300 for family for 2018)
  • Treat certain health and fitness expenses as qualified medical expenses for HSA, MSA, FSA, and HRA purposes
  • Allow individuals covered by a “direct primary care arrangement,” under which they receive ongoing care under a fixed periodic fee, as HSA-eligible, in the absence of any other HSA-disqualifying factor
  • Treat certain non-prescription medications and health aids (e.g., Ibuprofen, menstrual care products) as qualified medical expenses for HSA, MSA, HRA, and FSA purposes

H.R. 6311

H.R. 6311, Increasing Access to Lower Premium Plans and Expanding Health Savings Accounts Act of 2018, would do the following.

  • Increase the maximum annual HSA contribution to $6,650 for single coverage, $13,300 for family coverage (indexed)
  • If both spouses are eligible for the $1,000 HSA annual catch-up contribution, both amounts could be allocated to the account of one spouse
  • Treat individuals enrolled in Medicare Part A-only as HSA contribution-eligible, if no other disqualifying factors
  • If an HSA is established within 60 days after an individual is covered by an HSA-eligible HDHP, that HSA will  be treated as if it was established on the date coverage began, for purposes of covering medical expenses
  • Treat certain catastrophic and bronze-level health plans (as defined under the Patient Protection and Affordable Care Act, “Obamacare”) as HSA-eligible HDHP plans
  • Allow FSA year-to-year carryover of up to three times the annual FSA contribution limit (currently $2,650 for individual)

Watch the Ascensus News for further developments.