This bill, known as the ACCESS Act, introduces a significant new option for individuals obtaining health insurance through an Affordable Care Act (ACA) Exchange. It allows eligible insureds enrolled in an Exchange-provided high deductible health plan to elect to receive their cost-sharing reduction subsidies as direct contributions to a Health Savings Account (HSA) . This election means they would forgo the traditional reduced cost-sharing benefits provided under Section 1402 of the ACA, instead receiving equivalent funds into their HSA. Upon election, the health insurance issuer would make monthly payments to the individual's HSA, with the federal government subsequently reimbursing the issuer for these contributions. A key restriction is that any HSA receiving these payments must ensure that distributions are made exclusively through a qualified medical debit card for eligible medical expenses. These HSA contributions will also be treated as advance payments of the premium tax credit for recapture purposes. To support this initiative, the bill mandates that health insurance issuers offering silver-level plans must also offer an actuarially equivalent high-deductible health plan alternative. Additionally, both issuers and ACA Exchanges will be required to provide public education to prospective enrollees about this new HSA contribution option and how to establish and utilize an HSA. The legislation ensures a permanent appropriation for these new HSA contributions, alongside existing cost-sharing reduction payments, effective for months beginning after December 31, 2025.