Us Congress 2025-2026 Regular Session

Us Congress Senate Bill SB276 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	II
2	2	119THCONGRESS
3	3	1
4	4	STSESSION S. 276
5	5	To amend the Internal Revenue Code of 1986 to expand and improve health
6	6	savings accounts, and for other purposes.
7	7	IN THE SENATE OF THE UNITED STATES
8	8	JANUARY28, 2025
9	9	Mr. C
10	10	RUZ(for himself and Mr. MARSHALL) introduced the following bill;
11	11	which was read twice and referred to the Committee on Finance
12	12	A BILL
13	13	To amend the Internal Revenue Code of 1986 to expand
14	14	and improve health savings accounts, and for other purposes.
15	15	Be it enacted by the Senate and House of Representa-1
16	16	tives of the United States of America in Congress assembled, 2
17	17	SECTION 1. SHORT TITLE. 3
18	18	This Act may be cited as the ‘‘Personalized Care Act 4
19	19	of 2025’’. 5
20	20	SEC. 2. HEALTH SAVINGS ACCOUNT ELIGIBILITY. 6
21	21	(a) I
22	22	NGENERAL.—Paragraph (1) of section 223(c) 7
23	23	of the Internal Revenue Code of 1986 is amended to read 8
24	24	as follows: 9
25	25	VerDate Sep 11 2014 05:26 Feb 26, 2025 Jkt 059200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S276.IS S276
26	26	DMWilson on DSK7X7S144PROD with BILLS 2
27	27	•S 276 IS
28	28	‘‘(1) ELIGIBLE INDIVIDUAL.—The term ‘eligible 1
29	29	individual’ means, with respect to any month, any 2
30	30	individual if such individual is— 3
31	31	‘‘(A) covered under— 4
32	32	‘‘(i) a group or individual health plan, 5
33	33	‘‘(ii) health insurance coverage, in-6
34	34	cluding a short term limited duration plan 7
35	35	or medical indemnity plan, or 8
36	36	‘‘(iii) a government plan, including 9
37	37	coverage under the Medicare program 10
38	38	under part A or part B of title XVIII of 11
39	39	the Social Security Act, the Medicaid pro-12
40	40	gram under title XIX of such Act, the 13
41	41	CHIP program under title XXI of such 14
42	42	Act or a qualified CHIP look-alike pro-15
43	43	gram (as defined in section 2107(g) of 16
44	44	such Act), medical coverage under chapter 17
45	45	55 of title 10, United States Code (includ-18
46	46	ing coverage under the TRICARE pro-19
47	47	gram), a health care program under chap-20
48	48	ter 17 or 18 of title 38, United States 21
49	49	Code, as determined by the Secretary of 22
50	50	Veterans Affairs in coordination with the 23
51	51	Secretary of Health and Human Services 24
52	52	and the Secretary, a medical care program 25
53	53	VerDate Sep 11 2014 02:29 Feb 25, 2025 Jkt 059200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S276.IS S276
54	54	DMWilson on DSK7X7S144PROD with BILLS 3
55	55	•S 276 IS
56	56	of the Indian Health Service or a tribal or-1
57	57	ganization, or coverage under chapter 89 2
58	58	of title 5, United States Code, or 3
59	59	‘‘(B) a participant in a health care sharing 4
60	60	ministry (as defined in section 5
61	61	5000A(d)(2)(B)(ii) without regard to subclause 6
62	62	(IV) thereof), 7
63	63	as of the 1st day of such month.’’. 8
64	64	(b) C
65	65	ONFORMINGAMENDMENTS.— 9
66	66	(1) Subsection (c) of section 223 of the Internal 10
67	67	Revenue Code of 1986 is amended by striking para-11
68	68	graphs (2) and (3) and by redesignating paragraphs 12
69	69	(4) and (5) as paragraphs (2) and (3), respectively. 13
70	70	(2) Paragraphs (2)(A) and (2)(B) of section 14
71	71	223(b) of such Code are each amended by striking 15
72	72	‘‘a high deductible health plan’’ and inserting ‘‘a 16
73	73	health plan, insurance, or ministry described in sub-17
74	74	section (c)(1)’’. 18
75	75	(3) Paragraph (8)(A)(ii) of section 223(b) of 19
76	76	such Code is amended by striking ‘‘high deductible 20
77	77	health plan’’ and inserting ‘‘health plan, insurance, 21
78	78	or ministry described in subsection (c)(1)’’. 22
79	79	(4) Section 223(g)(1) of such Code is amend-23
80	80	ed— 24
81	81	VerDate Sep 11 2014 02:29 Feb 25, 2025 Jkt 059200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S276.IS S276
82	82	DMWilson on DSK7X7S144PROD with BILLS 4
83	83	•S 276 IS
84	84	(A) by striking ‘‘subsections (b)(2) and 1
85	85	(c)(2)(A)’’ both places it appears and inserting 2
86	86	‘‘subsection (b)(2)’’, and 3
87	87	(B) by striking ‘‘for ‘calendar year 2016’’’ 4
88	88	in subparagraph (B) and all that follows 5
89	89	through ‘‘‘calendar year 2003’.’’ and inserting 6
90	90	‘‘‘calendar year 1997’ for ‘calendar year 2016’ 7
91	91	in subparagraph (A)(ii) thereof.’’. 8
92	92	(5) The heading of subparagraph (B) of section 9
93	93	223(b)(8) of such Code is amended by striking 10
94	94	‘‘
95	95	HIGH DEDUCTIBLE HEALTH PLAN ’’. 11
96	96	(6) Section 26(b)(2)(S) of such Code is amend-12
97	97	ed by striking ‘‘high deductible health plan’’. 13
98	98	(7) The heading of paragraph (3) of section 14
99	99	106(e) of such Code is amended by striking ‘‘
100	100	HIGH 15
101	101	DEDUCTIBLE HEALTH PLAN ’’. 16
102	102	(8) Clause (ii) of section 106(e)(5)(B) of such 17
103	103	Code is amended by striking ‘‘a high deductible 18
104	104	health plan’’ and inserting ‘‘a health plan’’. 19
105	105	(9) Paragraph (9) of section 408(d) of such 20
106	106	Code is amended— 21
107	107	(A) by striking ‘‘the high deductible health 22
108	108	plan covering’’ in subparagraph (C)(i)(I) and 23
109	109	inserting ‘‘health plan, insurance, or ministry 24
110	110	of’’, 25
111	111	VerDate Sep 11 2014 02:29 Feb 25, 2025 Jkt 059200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S276.IS S276
112	112	DMWilson on DSK7X7S144PROD with BILLS 5
113	113	•S 276 IS
114	114	(B) by striking ‘‘a high deductible health 1
115	115	plan’’ the first place it appears in subparagraph 2
116	116	(C)(ii)(II) and inserting ‘‘a health plan, insur-3
117	117	ance, or ministry described in section 4
118	118	223(c)(1)’’, 5
119	119	(C) by striking ‘‘a high deductible health 6
120	120	plan’’ the second place it appears in subpara-7
121	121	graph (C)(ii)(II) and inserting ‘‘any such plan, 8
122	122	insurance, or ministry’’, and 9
123	123	(D) by striking ‘‘
124	124	HIGH DEDUCTIBLE 10
125	125	HEALTH PLAN’’ in the heading of subparagraph 11
126	126	(D). 12
127	127	(c) E
128	128	FFECTIVEDATE.—The amendments made by 13
129	129	this section shall apply to taxable years beginning after 14
130	130	December 31, 2025. 15
131	131	SEC. 3. INCREASE IN HSA CONTRIBUTION LIMITS. 16
132	132	(a) I
133	133	NGENERAL.—Paragraph (2) of section 223(b) 17
134	134	of the Internal Revenue Code of 1986 is amended— 18
135	135	(1) by striking ‘‘$2,250’’ in subparagraph (A) 19
136	136	and inserting ‘‘$10,800’’, and 20
137	137	(2) by striking ‘‘$4,500’’ in subparagraph (B) 21
138	138	and inserting ‘‘$29,500’’. 22
139	139	(b) C
140	140	OST-OF-LIVINGADJUSTMENT.—Paragraph (1) 23
141	141	of section 223(g) of the Internal Revenue Code of 1986, 24
142	142	as amended by section 2, is amended— 25
143	143	VerDate Sep 11 2014 02:29 Feb 25, 2025 Jkt 059200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S276.IS S276
144	144	DMWilson on DSK7X7S144PROD with BILLS 6
145	145	•S 276 IS
146	146	(1) by striking ‘‘Each’’ and inserting ‘‘In the 1
147	147	case of a taxable year beginning after 2026, each’’, 2
148	148	and 3
149	149	(2) by striking ‘‘calendar year 1997’’ and in-4
150	150	serting ‘‘calendar year 2025’’. 5
151	151	(c) E
152	152	FFECTIVEDATE.—The amendments made by 6
153	153	this section shall apply to taxable years beginning after 7
154	154	December 31, 2025. 8
155	155	SEC. 4. PAYMENT OF HEALTH PLAN AND HEALTH INSUR-9
156	156	ANCE PREMIUMS FROM HSA. 10
157	157	(a) I
158	158	NGENERAL.—Paragraph (2) of section 223(d) 11
159	159	of the Internal Revenue Code of 1986 is amended— 12
160	160	(1) by striking subparagraph (B), 13
161	161	(2) by redesignating subparagraphs (C) and 14
162	162	(D) as subparagraphs (B) and (C), respectively, 15
163	163	(3) by striking ‘‘Subparagraph (B) shall not 16
164	164	apply to any expense for coverage under’’ in sub-17
165	165	paragraph (B), as so redesignated, and inserting 18
166	166	‘‘Subparagraph (A) shall not apply to any payment 19
167	167	for insurance other than’’, and 20
168	168	(4) in subparagraph (B), as so redesignated— 21
169	169	(A) by striking ‘‘or’’ at the end of clause 22
170	170	(iii), 23
171	171	(B) by striking the period at the end of 24
172	172	clause (iv) and inserting ‘‘, or’’, and 25
173	173	VerDate Sep 11 2014 02:29 Feb 25, 2025 Jkt 059200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S276.IS S276
174	174	DMWilson on DSK7X7S144PROD with BILLS 7
175	175	•S 276 IS
176	176	(C) by adding at the end the following new 1
177	177	clause: 2
178	178	‘‘(v) a health plan or health insurance 3
179	179	coverage described in subsection 4
180	180	(c)(1)(A).’’. 5
181	181	(b) E
182	182	FFECTIVEDATE.—The amendments made by 6
183	183	this section shall apply to taxable years beginning after 7
184	184	December 31, 2025. 8
185	185	SEC. 5. TREATMENT OF MEDICAL CARE SERVICE ARRANGE-9
186	186	MENTS. 10
187	187	(a) I
188	188	NCLUSION ASMEDICALEXPENSES.—Paragraph 11
189	189	(2) of section 223(d) of the Internal Revenue Code of 12
190	190	1986, as amended by section 4, is further amended by 13
191	191	adding at the end the following new subparagraph: 14
192	192	‘‘(D) I
193	193	NCLUSION OF MEDICAL CARE SERV -15
194	194	ICE ARRANGEMENTS.—The term ‘qualified med-16
195	195	ical expenses’ shall include— 17
196	196	‘‘(i) periodic fees paid to a physician 18
197	197	for a defined set of medical services or for 19
198	198	the right to receive medical services on an 20
199	199	as-needed basis, and 21
200	200	‘‘(ii) amounts prepaid for medical 22
201	201	services designed to screen for, diagnose, 23
202	202	cure, mitigate, treat, or prevent disease 24
203	203	and promote wellness.’’. 25
204	204	VerDate Sep 11 2014 02:29 Feb 25, 2025 Jkt 059200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\S276.IS S276
205	205	DMWilson on DSK7X7S144PROD with BILLS 8
206	206	•S 276 IS
207	207	(b) ARRANGEMENT NOTTOBETREATED AS 1
208	208	H
209	209	EALTHINSURANCE.—Subsection (c) of section 223 of 2
210	210	the Internal Revenue Code of 1986, as amended by section 3
211	211	2(b), is further amended by adding at the end the fol-4
212	212	lowing new paragraph: 5
213	213	‘‘(4) T
214	214	REATMENT OF MEDICAL CARE SERVICE 6
215	215	ARRANGEMENTS.—An arrangement under which an 7
216	216	individual is provided medical services in exchange 8
217	217	for a fixed periodic fee or payment for such services 9
218	218	shall not be treated as a health plan, insurance, or 10
219	219	arrangement described in paragraph (1).’’. 11
220	220	(c) E
221	221	FFECTIVEDATE.—The amendments made by 12
222	222	this section shall apply to taxable years beginning after 13
223	223	December 31, 2025. 14
224	224	SEC. 6. PERIODIC PROVIDER FEES TREATED AS MEDICAL 15
225	225	CARE. 16
226	226	(a) I
227	227	NGENERAL.—Section 213(d) of the Internal 17
228	228	Revenue Code of 1986 is amended by adding at the end 18
229	229	the following new paragraph: 19
230	230	‘‘(12) P
231	231	ERIODIC PROVIDER FEES .—Periodic 20
232	232	fees paid for a defined set of medical services pro-21
233	233	vided on an as-needed basis shall be treated as 22
234	234	amounts paid for medical care.’’. 23
235	235	VerDate Sep 11 2014 02:29 Feb 25, 2025 Jkt 059200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\S276.IS S276
236	236	DMWilson on DSK7X7S144PROD with BILLS 9
237	237	•S 276 IS
238	238	(b) EFFECTIVEDATE.—The amendment made by 1
239	239	this section shall apply to taxable years beginning after 2
240	240	December 31, 2025. 3
241	241	SEC. 7. RESTORING LOWER PENALTY FOR NONQUALIFIED 4
242	242	DISTRIBUTIONS. 5
243	243	(a) I
244	244	NGENERAL.—Section 223(e)(4)(A) of the Inter-6
245	245	nal Revenue Code of 1986 is amended by striking ‘‘20 per-7
246	246	cent’’ and inserting ‘‘10 percent’’. 8
247	247	(b) E
248	248	FFECTIVEDATE.—The amendments made by 9
249	249	this section shall apply to distributions made in taxable 10
250	250	years beginning after December 31, 2025. 11
251	251	SEC. 8. TREATMENT OF HEALTH CARE SHARING MIN-12
252	252	ISTRIES. 13
253	253	(a) I
254	254	NCLUSION ASMEDICALEXPENSES.—Paragraph 14
255	255	(2) of section 223(d) of the Internal Revenue Code of 15
256	256	1986, as amended by sections 4 and 5, is further amended 16
257	257	by adding at the end the following new subparagraph: 17
258	258	‘‘(E) I
259	259	NCLUSION OF HEALTH CARE SHAR -18
260	260	ING MINISTRIES.—The term ‘qualified medical 19
261	261	expenses’ shall include amounts paid by a mem-20
262	262	ber of a health care sharing ministry (as de-21
263	263	fined in section 5000A(d)(2)(B)(ii) without re-22
264	264	gard to subclause (IV) thereof) for— 23
265	265	‘‘(i) the sharing of medical expenses 24
266	266	among members, and 25
267	267	VerDate Sep 11 2014 02:29 Feb 25, 2025 Jkt 059200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\S276.IS S276
268	268	DMWilson on DSK7X7S144PROD with BILLS 10
269	269	•S 276 IS
270	270	‘‘(ii) administrative fees of the min-1
271	271	istry.’’. 2
272	272	(b) H
273	273	EALTHCARESHARINGMINISTRYNOTTOBE 3
274	274	T
275	275	REATED ASHEALTHINSURANCE.—Subsection (c) of 4
276	276	section 223 of the Internal Revenue Code of 1986, as 5
277	277	amended by sections 2 and 5, is further amended by add-6
278	278	ing at the end the following new paragraph: 7
279	279	‘‘(5) T
280	280	REATMENT OF HEALTH CARE SHARING 8
281	281	MINISTRIES.—A health care sharing ministry (as de-9
282	282	fined in section 5000A(d)(2)(B)(ii) without regard 10
283	283	to subclause (IV) thereof) shall not be treated as a 11
284	284	health plan or insurance for purposes of this title.’’. 12
285	285	(c) E
286	286	FFECTIVEDATE.—The amendments made by 13
287	287	this section shall apply to taxable years beginning after 14
288	288	December 31, 2025. 15
289	289	SEC. 9. HEALTH CARE SHARING MINISTRY FEES TREATED 16
290	290	AS MEDICAL CARE. 17
291	291	(a) I
292	292	NGENERAL.—Section 213(d) of the Internal 18
293	293	Revenue Code of 1986, as amended by section 6, is further 19
294	294	amended by adding at the end the following new para-20
295	295	graph: 21
296	296	‘‘(13) H
297	297	EALTH CARE SHARING MINISTRIES .— 22
298	298	Amounts paid for membership in a health care shar-23
299	299	ing ministry (as defined in section 24
300	300	5000A(d)(2)(B)(ii) without regard to subclause (IV) 25
301	301	VerDate Sep 11 2014 02:29 Feb 25, 2025 Jkt 059200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\S276.IS S276
302	302	DMWilson on DSK7X7S144PROD with BILLS 11
303	303	•S 276 IS
304	304	thereof) shall be treated as amounts paid for medical 1
305	305	care.’’. 2
306	306	(b) E
307	307	FFECTIVEDATE.—The amendment made by 3
308	308	this section shall apply to taxable years beginning after 4
309	309	December 31, 2025. 5
310	310	Æ
311	311	VerDate Sep 11 2014 02:29 Feb 25, 2025 Jkt 059200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6301 E:\BILLS\S276.IS S276
312	312	DMWilson on DSK7X7S144PROD with BILLS