This legislation significantly broadens eligibility for Health Savings Accounts (HSAs) by amending the Internal Revenue Code. Under this bill, individuals covered by various government health plans, including Medicare, Medicaid, CHIP, or federal employee health benefits, would become eligible to contribute to HSAs. Furthermore, participants in health care sharing ministries are also made eligible, removing previous restrictions that linked HSA eligibility solely to high-deductible health plans. The legislation also expands the definition of qualified medical expenses that can be paid from an HSA to include periodic fees for medical services and prepaid medical services. It permits HSA funds to be used for paying premiums for any health plan or health insurance coverage. Additionally, it clarifies that health care sharing ministries are not treated as health plans for tax purposes, and their membership fees, shared medical expenses, and administrative fees are considered medical care expenses . These changes, along with allowing HSA funds for prescribed over-the-counter drugs and insulin, are set to apply to taxable years beginning after December 31, 2026.
Read twice and referred to the Committee on Finance.
Taxation
Health Savings Account Expansion Act
USA119th CongressS-4353| Senate
| Updated: 4/21/2026
This legislation significantly broadens eligibility for Health Savings Accounts (HSAs) by amending the Internal Revenue Code. Under this bill, individuals covered by various government health plans, including Medicare, Medicaid, CHIP, or federal employee health benefits, would become eligible to contribute to HSAs. Furthermore, participants in health care sharing ministries are also made eligible, removing previous restrictions that linked HSA eligibility solely to high-deductible health plans. The legislation also expands the definition of qualified medical expenses that can be paid from an HSA to include periodic fees for medical services and prepaid medical services. It permits HSA funds to be used for paying premiums for any health plan or health insurance coverage. Additionally, it clarifies that health care sharing ministries are not treated as health plans for tax purposes, and their membership fees, shared medical expenses, and administrative fees are considered medical care expenses . These changes, along with allowing HSA funds for prescribed over-the-counter drugs and insulin, are set to apply to taxable years beginning after December 31, 2026.