| 1 | 1 | | I |
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| 2 | 2 | | 119THCONGRESS |
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| 3 | 3 | | 1 |
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| 4 | 4 | | STSESSION H. R. 810 |
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| 5 | 5 | | To amend the Internal Revenue Code of 1986 to expand and improve health |
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| 6 | 6 | | savings accounts, and for other purposes. |
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| 7 | 7 | | IN THE HOUSE OF REPRESENTATIVES |
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| 8 | 8 | | JANUARY28, 2025 |
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| 9 | 9 | | Mr. R |
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| 10 | 10 | | OY(for himself, Mr. CRANE, Mr. BURLISON, Ms. HAGEMAN, Mr. HAR- |
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| 11 | 11 | | RISof Maryland, Mr. MOOREof Alabama, Mr. TIFFANY, Mr. OGLES, and |
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| 12 | 12 | | Mr. W |
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| 13 | 13 | | EBERof Texas) introduced the following bill; which was referred |
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| 14 | 14 | | to the Committee on Ways and Means |
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| 15 | 15 | | A BILL |
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| 16 | 16 | | To amend the Internal Revenue Code of 1986 to expand |
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| 17 | 17 | | and improve health savings accounts, and for other purposes. |
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| 18 | 18 | | Be it enacted by the Senate and House of Representa-1 |
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| 19 | 19 | | tives of the United States of America in Congress assembled, 2 |
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| 20 | 20 | | SECTION 1. SHORT TITLE. 3 |
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| 21 | 21 | | This Act may be cited as the ‘‘Personalized Care Act 4 |
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| 22 | 22 | | of 2025’’. 5 |
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| 23 | 23 | | SEC. 2. HEALTH SAVINGS ACCOUNT ELIGIBILITY. 6 |
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| 24 | 24 | | (a) I |
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| 25 | 25 | | NGENERAL.—Paragraph (1) of section 223(c) 7 |
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| 26 | 26 | | of the Internal Revenue Code of 1986 is amended to read 8 |
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| 27 | 27 | | as follows: 9 |
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| 29 | 29 | | kjohnson on DSK7ZCZBW3PROD with $$_JOB 2 |
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| 30 | 30 | | •HR 810 IH |
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| 31 | 31 | | ‘‘(1) ELIGIBLE INDIVIDUAL.—The term ‘eligible 1 |
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| 32 | 32 | | individual’ means, with respect to any month, any 2 |
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| 33 | 33 | | individual if such individual is— 3 |
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| 34 | 34 | | ‘‘(A) covered under— 4 |
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| 35 | 35 | | ‘‘(i) a group or individual health plan, 5 |
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| 36 | 36 | | ‘‘(ii) health insurance coverage, in-6 |
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| 37 | 37 | | cluding a short term limited duration plan 7 |
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| 38 | 38 | | or medical indemnity plan, or 8 |
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| 39 | 39 | | ‘‘(iii) a government plan, including 9 |
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| 40 | 40 | | coverage under the Medicare program 10 |
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| 41 | 41 | | under part A or part B of title XVIII of 11 |
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| 42 | 42 | | the Social Security Act, the Medicaid pro-12 |
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| 43 | 43 | | gram under title XIX of such Act, the 13 |
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| 44 | 44 | | CHIP program under title XXI of such 14 |
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| 45 | 45 | | Act or a qualified CHIP look-alike pro-15 |
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| 46 | 46 | | gram (as defined in section 2107(g) of 16 |
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| 47 | 47 | | such Act), medical coverage under chapter 17 |
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| 48 | 48 | | 55 of title 10, United States Code (includ-18 |
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| 49 | 49 | | ing coverage under the TRICARE pro-19 |
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| 50 | 50 | | gram), a health care program under chap-20 |
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| 51 | 51 | | ter 17 or 18 of title 38, United States 21 |
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| 52 | 52 | | Code, as determined by the Secretary of 22 |
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| 53 | 53 | | Veterans Affairs in coordination with the 23 |
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| 54 | 54 | | Secretary of Health and Human Services 24 |
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| 55 | 55 | | and the Secretary, a medical care program 25 |
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| 58 | 58 | | •HR 810 IH |
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| 59 | 59 | | of the Indian Health Service or a tribal or-1 |
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| 60 | 60 | | ganization, or coverage under chapter 89 2 |
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| 61 | 61 | | of title 5, United States Code, or 3 |
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| 62 | 62 | | ‘‘(B) a participant in a health care sharing 4 |
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| 63 | 63 | | ministry (as defined in section 5 |
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| 64 | 64 | | 5000A(d)(2)(B)(ii) without regard to subclause 6 |
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| 65 | 65 | | (IV) thereof), 7 |
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| 66 | 66 | | as of the 1st day of such month.’’. 8 |
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| 67 | 67 | | (b) C |
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| 68 | 68 | | ONFORMINGAMENDMENTS.— 9 |
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| 69 | 69 | | (1) Subsection (c) of section 223 of such Code 10 |
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| 70 | 70 | | is amended by striking paragraphs (2) and (3) and 11 |
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| 71 | 71 | | by redesignating paragraphs (4) and (5) as para-12 |
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| 72 | 72 | | graphs (2) and (3), respectively. 13 |
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| 73 | 73 | | (2) Paragraphs (2)(A) and (2)(B) of section 14 |
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| 74 | 74 | | 223(b) of such Code are each amended by striking 15 |
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| 75 | 75 | | ‘‘a high deductible health plan’’ and inserting ‘‘a 16 |
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| 76 | 76 | | health plan, insurance, or ministry described in sub-17 |
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| 77 | 77 | | section (c)(1)’’. 18 |
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| 78 | 78 | | (3) Paragraph (8)(A)(ii) of section 223(b) of 19 |
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| 79 | 79 | | such Code is amended by striking ‘‘high deductible 20 |
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| 80 | 80 | | health plan’’ and inserting ‘‘health plan, insurance, 21 |
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| 81 | 81 | | or ministry described in subsection (c)(1)’’. 22 |
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| 82 | 82 | | (4) Section 223(g)(1) of such Code is amend-23 |
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| 83 | 83 | | ed— 24 |
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| 85 | 85 | | kjohnson on DSK7ZCZBW3PROD with $$_JOB 4 |
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| 86 | 86 | | •HR 810 IH |
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| 87 | 87 | | (A) by striking ‘‘subsections (b)(2) and 1 |
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| 88 | 88 | | (c)(2)(A)’’ both places it appears and inserting 2 |
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| 89 | 89 | | ‘‘subsection (b)(2)’’, and 3 |
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| 90 | 90 | | (B) in subparagraph (B), by striking ‘‘for 4 |
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| 91 | 91 | | ‘calendar year 2016’’’ and all that follows 5 |
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| 92 | 92 | | through ‘‘‘calendar year 2003’.’’ and inserting 6 |
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| 93 | 93 | | ‘‘‘calendar year 1997’ for ‘calendar year 2016’ 7 |
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| 94 | 94 | | in subparagraph (A)(ii) thereof.’’. 8 |
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| 95 | 95 | | (5) The heading of subparagraph (B) of section 9 |
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| 96 | 96 | | 223(b)(8) of such Code is amended by striking 10 |
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| 97 | 97 | | ‘‘ |
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| 98 | 98 | | HIGH DEDUCTIBLE HEALTH PLAN ’’. 11 |
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| 99 | 99 | | (6) Section 26(b)(2)(S) of such Code is amend-12 |
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| 100 | 100 | | ed by striking ‘‘high deductible health plan’’. 13 |
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| 101 | 101 | | (7) The heading of paragraph (3) of section 14 |
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| 102 | 102 | | 106(e) of such Code is amended by striking ‘‘ |
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| 103 | 103 | | HIGH 15 |
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| 104 | 104 | | DEDUCTIBLE HEALTH PLAN ’’. 16 |
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| 105 | 105 | | (8) Clause (ii) of section 106(e)(5)(B) of such 17 |
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| 106 | 106 | | Code is amended by striking ‘‘a high deductible 18 |
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| 107 | 107 | | health plan’’ and inserting ‘‘a health plan’’. 19 |
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| 108 | 108 | | (9) Paragraph (9) of section 408(d) of such 20 |
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| 109 | 109 | | Code is amended— 21 |
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| 110 | 110 | | (A) by striking ‘‘the high deductible health 22 |
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| 111 | 111 | | plan covering’’ in subparagraph (C)(i)(I) and 23 |
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| 112 | 112 | | inserting ‘‘health plan, insurance, or ministry 24 |
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| 113 | 113 | | of’’, 25 |
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| 115 | 115 | | kjohnson on DSK7ZCZBW3PROD with $$_JOB 5 |
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| 116 | 116 | | •HR 810 IH |
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| 117 | 117 | | (B) by striking ‘‘a high deductible health 1 |
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| 118 | 118 | | plan’’ the first place it appears in subparagraph 2 |
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| 119 | 119 | | (C)(ii)(II) and inserting ‘‘a health plan, insur-3 |
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| 120 | 120 | | ance, or ministry described in section 4 |
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| 121 | 121 | | 223(c)(1)’’, 5 |
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| 122 | 122 | | (C) by striking ‘‘a high deductible health 6 |
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| 123 | 123 | | plan’’ the second place it appears in subpara-7 |
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| 124 | 124 | | graph (C)(ii)(II) and inserting ‘‘any such plan, 8 |
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| 125 | 125 | | insurance, or ministry’’, and 9 |
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| 126 | 126 | | (D) by striking ‘‘ |
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| 127 | 127 | | HIGH DEDUCTIBLE 10 |
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| 128 | 128 | | HEALTH PLAN’’ in the heading of subparagraph 11 |
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| 129 | 129 | | (D). 12 |
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| 130 | 130 | | (c) E |
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| 131 | 131 | | FFECTIVEDATE.—The amendments made by 13 |
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| 132 | 132 | | this section shall apply to taxable years beginning after 14 |
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| 133 | 133 | | December 31, 2024. 15 |
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| 134 | 134 | | SEC. 3. INCREASE IN HSA CONTRIBUTION LIMITS. 16 |
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| 135 | 135 | | (a) I |
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| 136 | 136 | | NGENERAL.—Paragraph (2) of section 223(b) 17 |
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| 137 | 137 | | of the Internal Revenue Code of 1986 is amended— 18 |
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| 138 | 138 | | (1) by striking ‘‘$2,250’’ in subparagraph (A) 19 |
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| 139 | 139 | | and inserting ‘‘$10,800’’, and 20 |
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| 140 | 140 | | (2) by striking ‘‘$4,500’’ in subparagraph (B) 21 |
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| 141 | 141 | | and inserting ‘‘$29,500’’. 22 |
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| 142 | 142 | | (b) C |
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| 143 | 143 | | OST-OF-LIVINGADJUSTMENT.—Paragraph (1) 23 |
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| 144 | 144 | | of section 223(g) of the Internal Revenue Code of 1986, 24 |
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| 145 | 145 | | as amended by section 2, is amended— 25 |
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| 148 | 148 | | •HR 810 IH |
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| 149 | 149 | | (1) by striking ‘‘Each’’ and inserting ‘‘In the 1 |
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| 150 | 150 | | case of a taxable year beginning after 2024, each’’, 2 |
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| 151 | 151 | | and 3 |
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| 152 | 152 | | (2) by striking ‘‘calendar year 1997’’ and in-4 |
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| 153 | 153 | | serting ‘‘calendar year 2023’’. 5 |
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| 154 | 154 | | (c) E |
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| 155 | 155 | | FFECTIVEDATE.—The amendments made by 6 |
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| 156 | 156 | | this section shall apply to taxable years beginning after 7 |
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| 157 | 157 | | December 31, 2024. 8 |
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| 158 | 158 | | SEC. 4. PAYMENT OF HEALTH PLAN AND HEALTH INSUR-9 |
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| 159 | 159 | | ANCE PREMIUMS FROM HSA. 10 |
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| 160 | 160 | | (a) I |
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| 161 | 161 | | NGENERAL.—Paragraph (2) of section 223(d) 11 |
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| 162 | 162 | | of the Internal Revenue Code of 1986 is amended— 12 |
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| 163 | 163 | | (1) by striking subparagraph (B), 13 |
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| 164 | 164 | | (2) by redesignating subparagraphs (C) and 14 |
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| 165 | 165 | | (D) as subparagraphs (B) and (C), respectively, 15 |
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| 166 | 166 | | (3) by striking ‘‘Subparagraph (B) shall not 16 |
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| 167 | 167 | | apply to any expense for coverage under’’ in sub-17 |
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| 168 | 168 | | paragraph (B), as so redesignated, and inserting 18 |
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| 169 | 169 | | ‘‘Subparagraph (A) shall not apply to any payment 19 |
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| 170 | 170 | | for insurance other than’’, and 20 |
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| 171 | 171 | | (4) in subparagraph (B), as so redesignated— 21 |
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| 172 | 172 | | (A) by striking ‘‘or’’ at the end of clause 22 |
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| 173 | 173 | | (iii), 23 |
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| 174 | 174 | | (B) by striking the period at the end of 24 |
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| 175 | 175 | | clause (iv) and inserting ‘‘, or’’, and 25 |
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| 178 | 178 | | •HR 810 IH |
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| 179 | 179 | | (C) by adding at the end the following new 1 |
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| 180 | 180 | | clause: 2 |
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| 181 | 181 | | ‘‘(v) a health plan or health insurance 3 |
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| 182 | 182 | | coverage described in subsection 4 |
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| 183 | 183 | | (c)(1)(A).’’. 5 |
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| 184 | 184 | | (b) E |
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| 185 | 185 | | FFECTIVEDATE.—The amendments made by 6 |
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| 186 | 186 | | this section shall apply to taxable years beginning after 7 |
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| 187 | 187 | | December 31, 2024. 8 |
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| 188 | 188 | | SEC. 5. TREATMENT OF MEDICAL CARE SERVICE ARRANGE-9 |
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| 189 | 189 | | MENTS. 10 |
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| 190 | 190 | | (a) I |
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| 191 | 191 | | NCLUSION ASMEDICALEXPENSES.—Paragraph 11 |
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| 192 | 192 | | (2) of section 223(d) of the Internal Revenue Code of 12 |
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| 193 | 193 | | 1986, as amended by section 4, is further amended by 13 |
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| 194 | 194 | | adding at the end the following new subparagraph: 14 |
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| 195 | 195 | | ‘‘(D) I |
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| 196 | 196 | | NCLUSION OF MEDICAL CARE SERV -15 |
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| 197 | 197 | | ICE ARRANGEMENTS.—The term ‘qualified med-16 |
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| 198 | 198 | | ical expenses’ shall include— 17 |
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| 199 | 199 | | ‘‘(i) periodic fees paid to a physician 18 |
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| 200 | 200 | | for a defined set of medical services or for 19 |
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| 201 | 201 | | the right to receive medical services on an 20 |
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| 202 | 202 | | as-needed basis, and 21 |
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| 203 | 203 | | ‘‘(ii) amounts prepaid for medical 22 |
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| 204 | 204 | | services designed to screen for, diagnose, 23 |
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| 205 | 205 | | cure, mitigate, treat, or prevent disease 24 |
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| 206 | 206 | | and promote wellness.’’. 25 |
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| 209 | 209 | | •HR 810 IH |
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| 210 | 210 | | (b) ARRANGEMENT NOTTOBETREATED AS 1 |
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| 211 | 211 | | H |
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| 212 | 212 | | EALTHINSURANCE.—Subsection (c) of section 223 of 2 |
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| 213 | 213 | | the Internal Revenue Code of 1986, as amended by section 3 |
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| 214 | 214 | | 2(b), is further amended by adding at the end the fol-4 |
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| 215 | 215 | | lowing new paragraph: 5 |
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| 216 | 216 | | ‘‘(4) T |
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| 217 | 217 | | REATMENT OF MEDICAL CARE SERVICE 6 |
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| 218 | 218 | | ARRANGEMENTS.—An arrangement under which an 7 |
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| 219 | 219 | | individual is provided medical services in exchange 8 |
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| 220 | 220 | | for a fixed periodic fee or payment for such services 9 |
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| 221 | 221 | | shall not be treated as a health plan, insurance, or 10 |
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| 222 | 222 | | arrangement described in paragraph (1).’’. 11 |
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| 223 | 223 | | (c) E |
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| 224 | 224 | | FFECTIVEDATE.—The amendments made by 12 |
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| 225 | 225 | | this section shall apply to taxable years beginning after 13 |
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| 226 | 226 | | December 31, 2024. 14 |
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| 227 | 227 | | SEC. 6. PERIODIC PROVIDER FEES TREATED AS MEDICAL 15 |
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| 228 | 228 | | CARE. 16 |
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| 229 | 229 | | (a) I |
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| 230 | 230 | | NGENERAL.—Section 213(d) of the Internal 17 |
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| 231 | 231 | | Revenue Code of 1986 is amended by adding at the end 18 |
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| 232 | 232 | | the following new paragraph: 19 |
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| 233 | 233 | | ‘‘(12) P |
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| 234 | 234 | | ERIODIC PROVIDER FEES .—Periodic 20 |
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| 235 | 235 | | fees paid for a defined set of medical services pro-21 |
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| 236 | 236 | | vided on an as-needed basis shall be treated as 22 |
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| 237 | 237 | | amounts paid for medical care.’’. 23 |
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| 240 | 240 | | •HR 810 IH |
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| 241 | 241 | | (b) EFFECTIVEDATE.—The amendment made by 1 |
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| 242 | 242 | | this section shall apply to taxable years beginning after 2 |
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| 243 | 243 | | December 31, 2024. 3 |
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| 244 | 244 | | SEC. 7. RESTORING LOWER PENALTY FOR NONQUALIFIED 4 |
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| 245 | 245 | | DISTRIBUTIONS. 5 |
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| 246 | 246 | | (a) I |
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| 247 | 247 | | NGENERAL.—Section 223(f)(4)(A) of the Inter-6 |
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| 248 | 248 | | nal Revenue Code of 1986 is amended by striking ‘‘20 per-7 |
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| 249 | 249 | | cent’’ and inserting ‘‘10 percent’’. 8 |
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| 250 | 250 | | (b) E |
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| 251 | 251 | | FFECTIVEDATE.—The amendments made by 9 |
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| 252 | 252 | | this section shall apply to distributions made in taxable 10 |
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| 253 | 253 | | years beginning after December 31, 2024. 11 |
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| 254 | 254 | | SEC. 8. TREATMENT OF HEALTH CARE SHARING MIN-12 |
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| 255 | 255 | | ISTRIES. 13 |
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| 256 | 256 | | (a) I |
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| 257 | 257 | | NCLUSION ASMEDICALEXPENSES.—Paragraph 14 |
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| 258 | 258 | | (2) of section 223(d) of the Internal Revenue Code of 15 |
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| 259 | 259 | | 1986, as amended by sections 4 and 5, is further amended 16 |
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| 260 | 260 | | by adding at the end the following new subparagraph: 17 |
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| 261 | 261 | | ‘‘(E) I |
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| 262 | 262 | | NCLUSION OF HEALTH CARE SHAR -18 |
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| 263 | 263 | | ING MINISTRIES.—The term ‘qualified medical 19 |
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| 264 | 264 | | expenses’ shall include amounts paid by a mem-20 |
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| 265 | 265 | | ber of a health care sharing ministry (as de-21 |
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| 266 | 266 | | fined in section 5000A(d)(2)(B)(ii) without re-22 |
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| 267 | 267 | | gard to subclause (IV) thereof) for— 23 |
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| 268 | 268 | | ‘‘(i) the sharing of medical expenses 24 |
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| 269 | 269 | | among members, and 25 |
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| 272 | 272 | | •HR 810 IH |
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| 273 | 273 | | ‘‘(ii) administrative fees of the min-1 |
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| 274 | 274 | | istry.’’. 2 |
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| 275 | 275 | | (b) H |
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| 276 | 276 | | EALTHCARESHARINGMINISTRYNOTTOBE 3 |
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| 277 | 277 | | T |
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| 278 | 278 | | REATED ASHEALTHINSURANCE.—Subsection (c) of 4 |
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| 279 | 279 | | section 223 of the Internal Revenue Code of 1986, as 5 |
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| 280 | 280 | | amended by sections 2 and 5, is further amended by add-6 |
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| 281 | 281 | | ing at the end the following new paragraph: 7 |
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| 282 | 282 | | ‘‘(5) T |
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| 283 | 283 | | REATMENT OF HEALTH CARE SHARING 8 |
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| 284 | 284 | | MINISTRIES.—A health care sharing ministry (as de-9 |
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| 285 | 285 | | fined in section 5000A(d)(2)(B)(ii) without regard 10 |
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| 286 | 286 | | to subclause (IV) thereof) shall not be treated as a 11 |
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| 287 | 287 | | health plan or insurance for purposes of this title.’’. 12 |
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| 288 | 288 | | (c) E |
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| 289 | 289 | | FFECTIVEDATE.—The amendments made by 13 |
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| 290 | 290 | | this section shall apply to taxable years beginning after 14 |
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| 291 | 291 | | December 31, 2024. 15 |
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| 292 | 292 | | SEC. 9. HEALTH CARE SHARING MINISTRY FEES TREATED 16 |
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| 293 | 293 | | AS MEDICAL CARE. 17 |
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| 294 | 294 | | (a) I |
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| 295 | 295 | | NGENERAL.—Section 213(d) of the Internal 18 |
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| 296 | 296 | | Revenue Code of 1986, as amended by section 6, is further 19 |
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| 297 | 297 | | amended by adding at the end the following new para-20 |
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| 298 | 298 | | graph: 21 |
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| 299 | 299 | | ‘‘(13) H |
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| 300 | 300 | | EALTH CARE SHARING MINISTRIES .— 22 |
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| 301 | 301 | | Amounts paid for membership in a health care shar-23 |
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| 302 | 302 | | ing ministry (as defined in section 24 |
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| 303 | 303 | | 5000A(d)(2)(B)(ii) without regard to subclause (IV) 25 |
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| 306 | 306 | | •HR 810 IH |
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| 307 | 307 | | thereof) shall be treated as amounts paid for medical 1 |
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| 308 | 308 | | care.’’. 2 |
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| 309 | 309 | | (b) E |
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| 310 | 310 | | FFECTIVEDATE.—The amendment made by 3 |
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| 311 | 311 | | this section shall apply to taxable years beginning after 4 |
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| 312 | 312 | | December 31, 2024. 5 |
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| 313 | 313 | | Æ |
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