Health savings accounts were poised to get a big boost in Trump’s signature tax package.
That didn’t happen.
While the House version of the bill included several changes to enhance the use and benefits of health savings accounts (HSAs), the version that ultimately passed made only three changes, Kaye L. Pestaina, vice president and director of KFF’s program on patient and consumer protection, told Yahoo Finance.
“It expands HSAs with new things people can use their HSA dollars for,” she said.
Here’s a rundown of the provisions included in the legislation that will be effective Jan. 2, 2026.
Read more: What is a health savings account (HSA)?
Concierge medical care qualifies. A Direct Primary Care (DPC) plan, often called a concierge healthcare plan, offers personalized, top-drawer healthcare services for a membership fee paid directly to a physician or practice for access to services.
“There had been some open questions about whether a consumer getting care from a DPC entity still was able to have a qualified HSA,” she said. “This will expand HSA holders’ incentive to use DPC.”
Under current law, many of these arrangements are not eligible to be paid for with your HSA money. In the new bill, certain DPC fees would be HSA eligible if the fee does not exceed $150 monthly for individuals, or $300 monthly where more than one individual is covered.
More health insurance plans can provide HSAs. Individual marketplace bronze and catastrophic plans would be treated as HSA-qualified high-deductible health plans. Under existing law, these plans offered in the individual market are not considered HDHPs, so they’re ineligible to be paired with an HSA.
To be HSA eligible, consumers must have an HDHP that meets specific IRS rules. Many bronze plans available on the marketplace have a high deductible, but they do not meet all of the IRS requirements (for instance, they have a different out-of-pocket maximum than the IRS requires).
Now, all bronze and catastrophic plans would be treated as HSA-qualified HDHPs and allow all consumers with these plans to use their HSA to pay for out-of-pocket costs.
“This would broaden Marketplace plan choices for consumers with HSAs,” Pestaina said.
Calling for care. The new legislation will allow those with an HSA to use those funds to pay for telehealth.
“These consumers would be able to access medical care (presumably any type) if provided via telehealth or remote monitoring without having to first pay the high deductible. This adds a benefit for HSA consumers that those with a high deductible plan but without an HSA do not have,” Pestaina said.
