Us Congress 2025-2026 Regular Session

Us Congress House Bill HB1157 Compare Versions

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Old	New	Differences
1	1	I
2	2	119THCONGRESS
3	3	1
4	4	STSESSION H. R. 1157
5	5	To allow individuals to elect to receive contributions to a health savings
6	6	account in lieu of reduced cost-sharing under health insurance obtained
7	7	through a health insurance Exchange.
8	8	IN THE HOUSE OF REPRESENTATIVES
9	9	FEBRUARY10, 2025
10	10	Mr. S
11	11	TEUBE(for himself and Mrs. CAMMACK) introduced the following bill;
12	12	which was referred to the Committee on Ways and Means, and in addi-
13	13	tion to the Committee on Energy and Commerce, for a period to be sub-
14	14	sequently determined by the Speaker, in each case for consideration of
15	15	such provisions as fall within the jurisdiction of the committee concerned
16	16	A BILL
17	17	To allow individuals to elect to receive contributions to a
18	18	health savings account in lieu of reduced cost-sharing
19	19	under health insurance obtained through a health insur-
20	20	ance Exchange.
21	21	Be it enacted by the Senate and House of Representa-1
22	22	tives of the United States of America in Congress assembled, 2
23	23	SECTION 1. SHORT TITLE. 3
24	24	This Act may be cited as the ‘‘Affordable Care and 4
25	25	Comprehensive Economic Support through Savings Act’’ 5
26	26	or the ‘‘ACCESS Act’’. 6
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29	29	•HR 1157 IH
30	30	SEC. 2. HEALTH SAVINGS ACCOUNT CONTRIBUTIONS IN 1
31	31	LIEU OF REDUCED COST-SHARING. 2
32	32	(a) I
33	33	NGENERAL.—Section 223 of the Internal Rev-3
34	34	enue Code of 1986 is amended by adding at the end the 4
35	35	following new subsection: 5
36	36	‘‘(i) H
37	37	EALTHSAVINGSACCOUNTCONTRIBUTIONS IN 6
38	38	L
39	39	IEU OFREDUCEDCOST-SHARING FOREXCHANGE-PRO-7
40	40	VIDEDPLANS.— 8
41	41	‘‘(1) I
42	42	N GENERAL.—In the case of any eligible 9
43	43	insured who is enrolled in an Exchange-provided 10
44	44	high deductible health plan for any month and who 11
45	45	elects (at such time and in such manner as the Sec-12
46	46	retary may provide) the application of this sub-13
47	47	section— 14
48	48	‘‘(A) section 1402 of the Patient Protec-15
49	49	tion and Affordable Care Act shall not apply to 16
50	50	such individual for such month, 17
51	51	‘‘(B) the health insurance issuer offering 18
52	52	such plan shall make a payment to a health 19
53	53	savings account of such individual for such 20
54	54	month in an amount equal to
55	55	1
56	56	⁄12of the annual 21
57	57	reduced cost-sharing actuarial equivalent 22
58	58	amount, and 23
59	59	‘‘(C) the Secretary shall make payments to 24
60	60	such health insurance issuer in amounts which 25
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63	63	•HR 1157 IH
64	64	are equal to the payments made by such issuer 1
65	65	under subparagraph (B). 2
66	66	‘‘(2) A
67	67	NNUAL REDUCED COST -SHARING ACTU-3
68	68	ARIAL EQUIVALENT AMOUNT .—For purposes of this 4
69	69	section, the term ‘annual reduced cost-sharing actu-5
70	70	arial equivalent amount’ means, with respect to any 6
71	71	Exchange-provided high deductible health plan en-7
72	72	rolled in by an eligible insured, an amount that 8
73	73	would produce an actuarial value equal to the actu-9
74	74	arial value of the reduction in cost-sharing (as deter-10
75	75	mined under section 1402 of the Patient Protection 11
76	76	and Affordable Care Act and without regard to any 12
77	77	election under this subsection) for the plan year de-13
78	78	termined by taking into account the household in-14
79	79	come of the eligible insured. 15
80	80	‘‘(3) R
81	81	ESTRICTION ON DISTRIBUTIONS .— 16
82	82	‘‘(A) I
83	83	N GENERAL.—Any trust which re-17
84	84	ceives a payment described in paragraph (1)(B) 18
85	85	shall not be treated as a health savings account 19
86	86	for purposes of this section unless the terms of 20
87	87	such trust require that, during any month dur-21
88	88	ing which such a payment is received, no dis-22
89	89	tribution may be made from such trust unless 23
90	90	such distribution is made to satisfy a charge 24
91	91	properly made to a qualified medical debit card. 25
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94	94	•HR 1157 IH
95	95	‘‘(B) QUALIFIED MEDICAL DEBIT CARD .— 1
96	96	For purposes of this paragraph, the term 2
97	97	‘qualified medical debit card’ means a debit 3
98	98	card which— 4
99	99	‘‘(i) is issued by a bank (as defined in 5
100	100	section 408(n)), 6
101	101	‘‘(ii) is provided by the trustee of the 7
102	102	health savings account to the designated 8
103	103	beneficiary, and 9
104	104	‘‘(iii) is encoded in such a manner 10
105	105	that the only expenses which may charged 11
106	106	with such card are amounts paid for med-12
107	107	ical care (as defined in section 213(d)). 13
108	108	‘‘(4) R
109	109	ECAPTURE OF EXCESS PAYMENTS .—For 14
110	110	purposes of applying the recapture rules of section 15
111	111	36B(f)(2)— 16
112	112	‘‘(A) payments made to the health savings 17
113	113	account of an individual under paragraph 18
114	114	(1)(B) shall be treated as an advance payment 19
115	115	of the credit allowed under section 36B, and 20
116	116	‘‘(B) the credit allowed under section 36B 21
117	117	shall be treated as having been increased by the 22
118	118	payments which would have been made to the 23
119	119	health savings account of such individual under 24
120	120	paragraph (1)(B) if such payments had been 25
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123	123	•HR 1157 IH
124	124	determined using the household income of such 1
125	125	individual for the taxable year referred to in 2
126	126	such section. 3
127	127	‘‘(5) O
128	128	THER DEFINITIONS AND SPECIAL 4
129	129	RULES.—For purposes of this section— 5
130	130	‘‘(A) E
131	131	XCHANGE-PROVIDED HIGH DEDUCT -6
132	132	IBLE HEALTH PLAN.—The term ‘Exchange-pro-7
133	133	vided high deductible health plan’ means, with 8
134	134	respect to any eligible insured, any high deduct-9
135	135	ible health plan enrolled in by such eligible in-10
136	136	sured through an Exchange established under 11
137	137	the Patient Protection and Affordable Care Act. 12
138	138	‘‘(B) E
139	139	LIGIBLE INSURED.—The term ‘eli-13
140	140	gible insured’ has the meaning given such term 14
141	141	in section 1402(b) of the Patient Protection 15
142	142	and Affordable Care Act. 16
143	143	‘‘(C) C
144	144	OORDINATION WITH CONTRIBUTION 17
145	145	LIMITS; ETC.—The payments described in para-18
146	146	graph (1)(B) shall not fail to be taken into ac-19
147	147	count under this section as contributions to the 20
148	148	health savings account to which paid and such 21
149	149	payments shall not be required to be made to 22
150	150	the extent that the eligible insured does not 23
151	151	have a health savings account or such account 24
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154	154	•HR 1157 IH
155	155	is prohibited from accepting such payment by 1
156	156	reason of subsection (d)(1)(A)(ii).’’. 2
157	157	(b) R
158	158	EQUIREMENTS RELATED TOEXCHANGE-PRO-3
159	159	VIDEDHIGHDEDUCTIBLEHEALTHPLANS.—Section 4
160	160	1301(a) of the Patient Protection and Affordable Care Act 5
161	161	(42 U.S.C. 18021(a)) is amended by adding at the end 6
162	162	the following new paragraph: 7
163	163	‘‘(5) R
164	164	EQUIREMENTS RELATED TO HIGH DE -8
165	165	DUCTIBLE HEALTH PLANS .— 9
166	166	‘‘(A) R
167	167	EQUIREMENT TO OFFER HIGH DE -10
168	168	DUCTIBLE HEALTH PLAN AS ALTERNATIVE .—A 11
169	169	health plan in the silver level of coverage in the 12
170	170	individual market which is not a high deductible 13
171	171	health plan shall not be treated as a qualified 14
172	172	health plan unless the health insurance issuer 15
173	173	offering such plan offers a high deductible 16
174	174	health plan which is actuarially equivalent to 17
175	175	such plan to any individual who would be an eli-18
176	176	gible insured (as defined in section 1402(b)) if 19
177	177	such individual were enrolled in such plan. 20
178	178	‘‘(B) R
179	179	EQUIREMENT TO MAKE HEALTH 21
180	180	SAVINGS ACCOUNT CONTRIBUTIONS UPON ELEC -22
181	181	TION OF ELIGIBLE INSURED .—A high deduct-23
182	182	ible health plan shall not be treated as a quali-24
183	183	fied health plan unless the health insurance 25
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186	186	•HR 1157 IH
187	187	issuer offering such plan complies with the re-1
188	188	quirement of section 223(i)(1)(B) of such Code 2
189	189	with respect to such plan. 3
190	190	‘‘(C) D
191	191	ETERMINATION OF ACTUARIAL 4
192	192	VALUE.—For purposes of this Act, the actuarial 5
193	193	value of a high deductible health plan shall take 6
194	194	into account payments made by the issuer to a 7
195	195	health savings account of the enrollee pursuant 8
196	196	to such plan. 9
197	197	‘‘(D) H
198	198	IGH DEDUCTIBLE HEALTH PLAN .— 10
199	199	For purposes of this paragraph, the term ‘high 11
200	200	deductible health plan’ has the meaning given 12
201	201	such term by section 223 of the Internal Rev-13
202	202	enue Code of 1986.’’. 14
203	203	(c) P
204	204	UBLICEDUCATION.—Beginning on January 1, 15
205	205	2026, each health insurance issuer offering coverage 16
206	206	through an Exchange established under the Patient Pro-17
207	207	tection and Affordable Care Act, and each such Exchange, 18
208	208	shall provide all prospective enrollees— 19
209	209	(1) information regarding the availability of in-20
210	210	surer-provided health savings account contributions 21
211	211	in lieu of reduced cost-sharing for silver level high 22
212	212	deductible health plans selected in the Exchange, 23
213	213	and 24
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216	216	•HR 1157 IH
217	217	(2) information regarding how to establish and 1
218	218	use a health savings account. 2
219	219	(d) P
220	220	ERMANENTAPPROPRIATION FOR COST-SHAR-3
221	221	INGREDUCTIONPAYMENTS AND HSA CONTRIBUTIONS 4
222	222	M
223	223	ADE INLIEU OFSUCHPAYMENTS.—Necessary amounts 5
224	224	are appropriated to the Secretary of the Treasury for 6
225	225	making payments described in section 1402(d)(3) of the 7
226	226	Patient Protection and Affordable Care Act, and pay-8
227	227	ments described in section 223(i)(1)(C) of the Internal 9
228	228	Revenue Code of 1986 (as added by this section), for 10
229	229	months beginning after December 31, 2025. 11
230	230	(e) E
231	231	FFECTIVEDATE.—The amendments made by 12
232	232	this section shall apply to months beginning after Decem-13
233	233	ber 31, 2025. 14
234	234	Æ
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