This bill — the Restoring Access to Medication and Modernizing Health Savings Accounts Act — would overhaul health savings accounts (HSAs) to make them more useful for covering healthcare costs related to medication and other expenses that contribute to an individual’s health. It contains the legislative text of five related bills that passed the House Ways and Means Committee with bipartisan support, summaries of which can be found below.
Restoring Access to Medication Act of 2018: This section of the bill would repeal a provision of the Affordable Care Act (commonly known as Obamacare) that limits payments for medications from HSAs, medical savings accounts (MSAs), flexible spending arrangements (FSAs), and health reimbursement arrangements (HRAs) to only prescription drugs. In effect, this would allow funds from such accounts to be used for over-the-counter drugs, and also menstrual care products.
Bipartisan HSA Improvement Act: This section of the bill would make three changes to HSAs: 1) it’d clarify that employment-related services (like on-site clinics) wouldn’t be considered disqualifying coverage under HSAs; 2) eligible individuals could make HSA contributions if a spouse has a flexible spending account (FSA) as long as the FSA doesn’t reimburse expenses of the spouse with the HSA; and 3) FSAs and Health Reimbursement Accounts (HRA) could be terminated or converted to fund HSAs.
Personal Health Investment Today (PHIT) Act: This section of the bill would allow individuals to pay for a gym membership, exercise classes, or related equipment for themselves or their dependants using funds from a tax-preferred health savings account (HSA) or flexible spend account (FSA).
The overall limitation on such tax-preferred expenses would be $500 annually (or twice that for a joint return or head of household), while the limit for safety equipment would be $250 annually. These amounts would be adjusted for inflation and rounded to the nearest $10 each year. This legislation would take effect for tax years beginning after December 31, 2018.
Golfing, hunting, sailing, and riding wouldn’t be considered qualified physical activities. Memberships at facilities offering those activities, or at private clubs owned and operated by members, wouldn’t be qualified. Exercise videos, books, or similar materials wouldn’t be considered qualified exercise equipment.
Primary Care Enhancement Act: This section of the bill would prevent individuals who participate in a direct primary care (DPC) arrangement from losing their HSA eligibility because of their participation. It’d also allow funds from HSAs to be used for DPC provider fees.
Promoting High-Value Health Care Through Flexibility for High Deductible Health Plans Act: This section of the bill would expand access and enhance the utility of HSAs by allowing plans to cover for high value, low-cost services like telehealth, chronic disease management, diabetic testing strips, or primary care visits below the deductible while maintaining their HSA eligibility.