The House Ways and Means Committee met on Wednesday, July 11, 2018 for a full committee markup of several bills from the Subcommittee on Health that would improve the usability of and expand access to health savings accounts (HSAs) and other consumer-directed health products.
The committee described these bills as “aimed at expanding consumer-directed health care and lowering premiums.”
Chairman Kevin Brady (R-TX) spoke in his opening remarks about the ability of HSAs to expand consumer choice in the marketplace and drive down premiums. Chairman Brady said:
Health Savings Accounts are an important tool for families to set aside money that’s tax-free to pay for needed health care expenses. This helps reduce the burden of high health care costs and enables families to plan ahead for events like the birth of a child. It’s no wonder why so many families think HSAs are so great. They give choice and lower costs.
In the meeting, members of the committee voted on amendments to proposed legislation and voted on submitting favorable reports on the legislation to the full House of Representatives.
While there were bills that gained significant bipartisan support, including the Bipartisan HSA Improvement Act of 2018, the majority of votes were along party lines with Republican members in favor and Democrat members opposed.
The committee considered the following pieces of legislation:
- H.R. 6301, “To amend the Internal Revenue Code of 1986 to provide high deductible health plans with first dollar coverage flexibility.”
- Allowing HSA-eligible high deductible health plans (“HDHPs”) to provide first dollar coverage for telemedicine and chronic disease management.
- 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.”
- Defining primary care service arrangements as care rather than insurance so participation is not considered disqualifying coverage for purposes of HSA eligibility.
- H.R. 6305, “Bipartisan HSA Improvement Act of 2018.”
- Includes multiple improvements such as:
- Creating a mechanism to rollover funds from an FSA or HRA to an HSA and improve the interaction between these accounts;
- Allowing contributions if a spouse is enrolled in an FSA;
- Defining dependents as children Age 26 and younder;
- Allowing on-site clinics, telehealth, and chronic disease management without impacting HSA eligibility;
- Permitting reimbursement of wellness and exercise programs from an HSA.
- H.R. 6312, “Personal Health Investment Today (PHIT) Act.”
- Defining up to $2,000 in annual health and wellness expenditures as qualified medical expenses.
- H.R. 6306, “To amend the Internal Revenue Code of 1986 to increase the contribution limitation for health savings accounts, and for other purposes”.
- Increasing the contribution limit to the out of pocket maximum for HDHPs.
- H.R. 6313, “Responsible Additions and Increases to Sustain Employee Health Benefits Act of 2018.”
- Allowing carryover of the entire balance of an FSA at the end of the plan year.
- H.R. 6314, “Health Savings Act of 2018.”
- Treating Bronze and Catastrophic health plans as HDHPs for HSA eligibility.
- 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.”
- 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.”
- H.R. 6199, “To amend the Internal Revenue Code of 1986 to include certain over-the-counter medical products as qualified medical expenses.”
- 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.”
Following a favorable report to the full house, the sponsors of this legislation will work with leadership to determine if there are vehicles that would allow passage of these improvements to consumer-directed health plans and accounts.