Consumer Driven Health Care Activity on the Hill

posted on

The House Ways and Means Committee marked up several bills mid-July that would raise contribution limits for health savings accounts (HSAs) and expand the allowable uses of these accounts, at a cost of $41 billion over ten years, the Joint Committee on Taxation (JCT) estimates. Collectively all the bills would cost an estimated $92 billion over the next ten years.

The House is scheduled to take up the bills passed on from the Ways and Means Committee the week of July 22nd. It will be interesting to see what progress they may make in an election year and how any of this will impact benefits in the near future, if at all.  Many of the bills offer improvements to HSAs, which would be great, if they are passed in time for open enrollment season starting soon for many calendar year plans.

A summary of what the House has for consideration is below:

(H.R. 6199) To amend the Internal Revenue Code of 1986 to include certain over-the-counter medical products as qualified medical expenses

Sponsored by Reps. Lynn Jenkins (R-KS) and Grace Meng (D-NY)

The bill reverses Obamacare’s prohibition on using tax-favored health accounts to purchase over-the-counter (OTC) medical products and adds feminine or “menstrual care” products to the list of qualified medical expenses for the purposes of these tax-favored health accounts.

(H.R. 6301) To amend the Internal Revenue Code of 1986 to provide high deductible health plans with first dollar coverage flexibility 

Sponsored by Health Subcommittee Chairman Peter Roskam (R-IL) and Rep. Mike Thompson (D-CA)

The bill expands access and enhances the utility of health savings accounts (HSAs) by offering health plans a certain amount of flexibility in their plan design while still maintaining eligibility for HSA contributions. This flexibility will allow insurers to offer coverage for high-value, low-cost services like telehealth, chronic disease management (e.g. diabetic testing strips), or primary care visits below the deductible.

(H.R. 6305) To amend the Internal Revenue Code of 1986 to improve access to health care through modernized health savings accounts

Sponsored by Reps. Mike Kelly (R-PA) and Earl Blumenauer (D-OR)

The bill expands access and enhances the utility of HSAs through three common-sense improvements to the rules governing HSAs: (1) clarifying that certain employment related services (such as on-site clinics) are not treated as disqualifying coverage for purposes of HSAs; (2) allowing an eligible individual to make HSA contributions if a spouse has a Flexible Spending Account (FSA), provided that FSA does not also reimburse for expenses of the spouse with the HSA; and (3) allowing FSA and Health Reimbursement Account (HRA) terminations or conversions to fund HSAs.

(H.R. 6317) To amend the Internal Revenue Code of 1986 to provide that direct primary care service arrangements do not disqualify deductible health savings account contributions, and for other purposes 

Sponsored by Reps. Erik Paulsen (R-MN) and Earl Blumenauer (D-OR)

The bill allows HSA-eligible individuals that participate in a direct primary care (DPC) arrangement not to lose their HSA-eligibility merely because of their participation in a DPC. In addition, it allows DPC provider fees to be paid for out of HSAs.

(H.R. 6312) To amend the Internal Revenue Code of 1986 to treat certain amounts paid for physical activity, fitness, and exercise as amounts paid for medical care 

Sponsored by Reps. Jason Smith (R-MO) and Ron Kind (D-WI)

The bill adds qualified sports and fitness expenses to the definition of qualified medical expenses.

(H.R. 6309) To amend the Internal Revenue Code of 1986 to allow individuals entitled to Medicare Part A by reason of being over age 65 to contribute to health savings accounts 

Sponsored by Rep. Erik Paulsen (R-MN)

The bill expands access to HSAs for working seniors.

(H.R. 6306) To amend the Internal Revenue Code of 1986 to increase the contribution limitation for health savings accounts, and for other purposes 

Sponsored by Rep. Erik Paulsen (R-MN) 

The bill expands access and enhances the utility of HSAs by: (1) increasing the contributions limits for HSAs; (2) permitting spousal catch-up contributions into the same account; and (3) creating a grace period for medical expenses incurred before the establishment of an HSA.

(H.R. 6314) To amend the Internal Revenue Code of 1986 to allow bronze and catastrophic plans in connection with health savings accounts

Sponsored by Rep. Michael Burgess (R-TX) and Health Subcommittee Chairman Peter Roskam (R-IL) 

The bill expands eligibility and access to HSAs by allowing plans categorized as catastrophic and bronze in the individual and small group markets to qualify for HSA contributions.

(H.R. 6311) To amend the Internal Revenue Code of 1986 and the Patient Protection and Affordable Care Act to modify the definition of qualified health plan for purposes of the health insurance premium tax credit and to allow individuals purchasing health insurance in the individual market to purchase a lower premium copper plan

Sponsored by Health Subcommittee Chairman Peter Roskam (R-IL) and Rep. Michael Burgess (R-TX) 

The bill provides an off-ramp from Obamacare’s rising premiums and limited choices by allowing the premium tax credit to be used for qualified plans offered outside of the law’s exchanges and Healthcare.gov. In addition, it expands access to the lowest-premium plans available (“catastrophic” plans) for all individuals purchasing coverage in the individual market and allows the premium tax credit to be used to offset the cost of such plans.

(H.R. 6313) To amend the Internal Revenue Code of 1986 to allow the carry forward of health flexible spending arrangement account balances 

Sponsored by Rep. Steve Stivers (R-OH) 

The bill allows balances in FSAs to be carried forward each year.

(H.R. 4616) To amend the Patient Protection and Affordable Care Act to provide for a temporary moratorium on the employer mandate and to provide for a delay in the implementation of the excise tax on high cost employer-sponsored health coverage 

Sponsored by Reps. Devin Nunes (R-CA) and Mike Kelly (R-PA) 

The bill provides retroactive relief from Obamacare’s employer mandate and one additional year of delay in the implementation of the law’s Cadillac tax.

We will continue to monitor this activity and will provide updates as information becomes available.

For more information on the activity in the House, please check https://rules.house.gov/

 

Categories: Benefits in General, Health Care Reform, Compliance, Health Care in General | Tags: HSA , Health Savings Accounts , FSA , Flexible Spending Account , OTC , Internal Revenue Code , Medicare and HSA eligibility , Premium Tax Credit , Medical Device Tax , Cadillac Tax , IRS , ACA , HDHP | Return