US Codex
Bill
Notes

Title II — Enhancing access to tax-preferred health accounts

S. 12 · 116th Congress · Jan 3, 2019 · Lineage

II Enhancing access to tax-preferred health accounts

Sec. 201 Allow both spouses to make catch-up contributions to the same HSA account

(a)
In general— Paragraph (5) of section 223(b) is amended to read as follows:

“(5) Special rule for married individuals with family coverage

“(A) In general—In the case of individuals who are married to each other, if both spouses are eligible individuals and either spouse has family coverage under an HSA-qualified health plan as of the first day of any month—

“(i) the limitation under paragraph (1) shall be applied by not taking into account any other HSA-qualified health plan coverage of either spouse (and if such spouses both have family coverage under separate HSA-qualified health plans, only one such coverage shall be taken into account),

“(ii) such limitation (after application of clause (i)) shall be reduced by the aggregate amount paid to Archer MSAs of such spouses for the taxable year, and

“(iii) such limitation (after application of clauses (i) and (ii)) shall be divided equally between such spouses unless they agree on a different division.

“(B) Treatment of additional contribution amounts—If both spouses referred to in subparagraph (A) have attained age 55 before the close of the taxable year, the limitation referred to in subparagraph (A)(iii) which is subject to division between the spouses shall include the additional contribution amounts determined under paragraph (3) for both spouses. In any other case, any additional contribution amount determined under paragraph (3) shall not be taken into account under subparagraph (A)(iii) and shall not be subject to division between the spouses.”

(b)
Effective date— The amendment made by this section shall apply to taxable years beginning after the date of the enactment of this Act.

Sec. 202 Provisions relating to Medicare

(a)
Individuals over age 65 only enrolled in Medicare Part A— Paragraph (7) of section 223(b) is amended by adding at the end the following: “This paragraph shall not apply to any individual during any period for which the individual's only entitlement to such benefits is an entitlement to hospital insurance benefits under part A of title XVIII of such Act pursuant to an enrollment for such hospital insurance benefits under section 226(a) of such Act.”.
(b)
Medicare beneficiaries participating in Medicare advantage MSA may contribute their own money to their MSA—
(1)
In general— Subsection (b) of section 138 is amended by striking paragraph (2) and by redesignating paragraphs (3) and (4) as paragraphs (2) and (3), respectively.
(2)
Conforming amendment— Paragraph (4) of section 138(c) is amended by striking “and paragraph (2)”.
(c)
Effective date— The amendments made by this section shall apply to taxable years beginning after the date of the enactment of this Act.

Sec. 203 Individuals eligible for Indian Health Service assistance

(a)
In general— Paragraph (1) of section 223(c) is amended by adding at the end the following new subparagraph:

“(D) Special rule for individuals eligible for assistance under Indian Health Service programs—For purposes of subparagraph (A)(ii), an individual shall not be treated as covered under a health plan described in such subparagraph merely because the individual receives hospital care or medical services under a medical care program of the Indian Health Service or of a tribal organization.”

(b)
Effective date— The amendment made by this section shall apply to taxable years beginning after the date of the enactment of this Act.

Sec. 204 Members of health care sharing ministries eligible to establish health savings accounts

(a)
In general— Section 223 is amended by adding at the end the following new subsection:

“(i) Application to health care sharing ministries—For purposes of this section, membership in a health care sharing ministry (as defined in section 5000A(d)(2)(B)(ii)) shall be treated as coverage under an HSA-qualified health plan.”

(b)
Effective date— The amendment made by this section shall apply to taxable years beginning after the date of the enactment of this Act.

Sec. 205 Treatment of direct primary care service arrangements

(a)
In general— Section 223(c) is amended by adding at the end the following new paragraph:

“(6) Treatment of direct primary care service arrangements—An arrangement under which an individual is provided coverage restricted to primary care services in exchange for a fixed periodic fee or payment for primary care services—

“(A) shall not be treated as a health plan for purposes of paragraph (1)(A)(ii), and

“(B) shall not be treated as insurance for purposes of subsection (d)(2)(B).”

(b)
Effective date— The amendment made by this section shall apply to taxable years beginning after the date of the enactment of this Act.

Sec. 206 Individuals eligible for on-site medical clinic coverage

(a)
In general— Paragraph (1) of section 223(c), as amended by sections 203, is amended by adding at the end the following new subparagraph:

“(E) Special rule for individuals eligible for on-site medical clinic coverage

“(i) In general—For purposes of subparagraph (A)(ii), an individual shall not be treated as covered under a health plan described in such subparagraph merely because the individual is eligible to receive health care benefits from an on-site medical clinic of employer of the individual or the individual's spouse if such health care benefits are not significant benefits.

“(ii) Included benefits—For purposes of clause (i), the following health care benefits shall be considered to be benefits which are not significant benefits:

“(I) Physicals and immunizations.

“(II) Injecting antigens provided by employees.

“(III) Medications available without a prescription, such as pain relievers and antihistamines.

“(IV) Treatment for injuries occurring at the employer's place of employment or otherwise in the course of employment.

“(V) Tests for infectious diseases and conditions, such as streptococcal sore throat.

“(VI) Monitoring of chronic conditions, such as diabetes.

“(VII) Drug testing.

“(VIII) Hearing or vision screenings and related services.

“(IX) Other services and treatments of a similar nature to the services described in subclauses (I) through (VIII).

“(iii) Aggregation rules—For purposes of clause (i), all persons treated as a single employer under subsection (b), (c), (m), or (o) of section 414 shall be treated as a single employer.”

(b)
Effective date— The amendment made by this section shall apply to taxable years beginning after the date of the enactment of this Act.

Sec. 207 Treatment of embedded deductibles

(a)
In general— Paragraph (2) of section 223(c) is amended by adding at the end the following new subparagraph:

“(E) Treatment of embedded deductible—A health plan providing family coverage that has an annual deductible for all covered individuals under the plan of at least the amount described in subparagraph (A)(i)(II) shall not fail to be treated as an HSA-qualified health plan solely because it covers expenses with respect to an individual under that plan that exceed an embedded deductible which is equal to or in excess of the amount described in subparagraph (A)(i)(I).”

(b)
Effective date— The amendment made by this section shall apply to taxable years beginning after the date of the enactment of this Act.