[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1157 Introduced in House (IH)]
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119th CONGRESS
1st Session
H. R. 1157
To allow individuals to elect to receive contributions to a health
savings account in lieu of reduced cost-sharing under health insurance
obtained through a health insurance Exchange.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
February 10, 2025
Mr. Steube (for himself and Mrs. Cammack) introduced the following
bill; which was referred to the Committee on Ways and Means, and in
addition to the Committee on Energy and Commerce, for a period to be
subsequently determined by the Speaker, in each case for consideration
of such provisions as fall within the jurisdiction of the committee
concerned
_______________________________________________________________________
A BILL
To allow individuals to elect to receive contributions to a health
savings account in lieu of reduced cost-sharing under health insurance
obtained through a health insurance Exchange.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Affordable Care and Comprehensive
Economic Support through Savings Act'' or the ``ACCESS Act''.
SEC. 2. HEALTH SAVINGS ACCOUNT CONTRIBUTIONS IN LIEU OF REDUCED COST-
SHARING.
(a) In General.--Section 223 of the Internal Revenue Code of 1986
is amended by adding at the end the following new subsection:
``(i) Health Savings Account Contributions in Lieu of Reduced Cost-
Sharing for Exchange-Provided Plans.--
``(1) In general.--In the case of any eligible insured who
is enrolled in an Exchange-provided high deductible health plan
for any month and who elects (at such time and in such manner
as the Secretary may provide) the application of this
subsection--
``(A) section 1402 of the Patient Protection and
Affordable Care Act shall not apply to such individual
for such month,
``(B) the health insurance issuer offering such
plan shall make a payment to a health savings account
of such individual for such month in an amount equal to
\1/12\ of the annual reduced cost-sharing actuarial
equivalent amount, and
``(C) the Secretary shall make payments to such
health insurance issuer in amounts which are equal to
the payments made by such issuer under subparagraph
(B).
``(2) Annual reduced cost-sharing actuarial equivalent
amount.--For purposes of this section, the term `annual reduced
cost-sharing actuarial equivalent amount' means, with respect
to any Exchange-provided high deductible health plan enrolled
in by an eligible insured, an amount that would produce an
actuarial value equal to the actuarial value of the reduction
in cost-sharing (as determined under section 1402 of the
Patient Protection and Affordable Care Act and without regard
to any election under this subsection) for the plan year
determined by taking into account the household income of the
eligible insured.
``(3) Restriction on distributions.--
``(A) In general.--Any trust which receives a
payment described in paragraph (1)(B) shall not be
treated as a health savings account for purposes of
this section unless the terms of such trust require
that, during any month during which such a payment is
received, no distribution may be made from such trust
unless such distribution is made to satisfy a charge
properly made to a qualified medical debit card.
``(B) Qualified medical debit card.--For purposes
of this paragraph, the term `qualified medical debit
card' means a debit card which--
``(i) is issued by a bank (as defined in
section 408(n)),
``(ii) is provided by the trustee of the
health savings account to the designated
beneficiary, and
``(iii) is encoded in such a manner that
the only expenses which may charged with such
card are amounts paid for medical care (as
defined in section 213(d)).
``(4) Recapture of excess payments.--For purposes of
applying the recapture rules of section 36B(f)(2)--
``(A) payments made to the health savings account
of an individual under paragraph (1)(B) shall be
treated as an advance payment of the credit allowed
under section 36B, and
``(B) the credit allowed under section 36B shall be
treated as having been increased by the payments which
would have been made to the health savings account of
such individual under paragraph (1)(B) if such payments
had been determined using the household income of such
individual for the taxable year referred to in such
section.
``(5) Other definitions and special rules.--For purposes of
this section--
``(A) Exchange-provided high deductible health
plan.--The term `Exchange-provided high deductible
health plan' means, with respect to any eligible
insured, any high deductible health plan enrolled in by
such eligible insured through an Exchange established
under the Patient Protection and Affordable Care Act.
``(B) Eligible insured.--The term `eligible
insured' has the meaning given such term in section
1402(b) of the Patient Protection and Affordable Care
Act.
``(C) Coordination with contribution limits; etc.--
The payments described in paragraph (1)(B) shall not
fail to be taken into account under this section as
contributions to the health savings account to which
paid and such payments shall not be required to be made
to the extent that the eligible insured does not have a
health savings account or such account is prohibited
from accepting such payment by reason of subsection
(d)(1)(A)(ii).''.
(b) Requirements Related to Exchange-Provided High Deductible
Health Plans.--Section 1301(a) of the Patient Protection and Affordable
Care Act (42 U.S.C. 18021(a)) is amended by adding at the end the
following new paragraph:
``(5) Requirements related to high deductible health
plans.--
``(A) Requirement to offer high deductible health
plan as alternative.--A health plan in the silver level
of coverage in the individual market which is not a
high deductible health plan shall not be treated as a
qualified health plan unless the health insurance
issuer offering such plan offers a high deductible
health plan which is actuarially equivalent to such
plan to any individual who would be an eligible insured
(as defined in section 1402(b)) if such individual were
enrolled in such plan.
``(B) Requirement to make health savings account
contributions upon election of eligible insured.--A
high deductible health plan shall not be treated as a
qualified health plan unless the health insurance
issuer offering such plan complies with the requirement
of section 223(i)(1)(B) of such Code with respect to
such plan.
``(C) Determination of actuarial value.--For
purposes of this Act, the actuarial value of a high
deductible health plan shall take into account payments
made by the issuer to a health savings account of the
enrollee pursuant to such plan.
``(D) High deductible health plan.--For purposes of
this paragraph, the term `high deductible health plan'
has the meaning given such term by section 223 of the
Internal Revenue Code of 1986.''.
(c) Public Education.--Beginning on January 1, 2026, each health
insurance issuer offering coverage through an Exchange established
under the Patient Protection and Affordable Care Act, and each such
Exchange, shall provide all prospective enrollees--
(1) information regarding the availability of insurer-
provided health savings account contributions in lieu of
reduced cost-sharing for silver level high deductible health
plans selected in the Exchange, and
(2) information regarding how to establish and use a health
savings account.
(d) Permanent Appropriation for Cost-Sharing Reduction Payments and
HSA Contributions Made in Lieu of Such Payments.--Necessary amounts are
appropriated to the Secretary of the Treasury for making payments
described in section 1402(d)(3) of the Patient Protection and
Affordable Care Act, and payments described in section 223(i)(1)(C) of
the Internal Revenue Code of 1986 (as added by this section), for
months beginning after December 31, 2025.
(e) Effective Date.--The amendments made by this section shall
apply to months beginning after December 31, 2025.
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