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Adds a new subsection (i) to 26 U.S.C. 223 authorizing issuer payments to an enrollee's health savings account in lieu of ACA cost-sharing reductions for Exchange-provided high deductible health plans, directs the Secretary to reimburse issuers for those payments, sets recapture/credit-treatment rules referencing section 36B, imposes distribution restrictions while such payments are received, and provides definitions and coordination with HSA contribution limits.
Amends 42 U.S.C. 18021(a) by adding a new paragraph (5) establishing requirements related to high deductible health plans: requiring that non-HDP silver-level plans offer an actuarially equivalent HDHP alternative to individuals who would be eligible insureds, requiring HDHPs to comply with the new IRC 223(i)(1)(B) HSA-contribution requirement, specifying that actuarial value calculations must account for issuer HSA payments, and defining HDHP by reference to the Internal Revenue Code.
Allows people who buy Exchange-offered high-deductible health plans (HDHPs) to get their plan’s value delivered as an insurer deposit into a Health Savings Account (HSA) instead of reduced cost-sharing at the point of care. Insurers will be reimbursed by the federal government for those HSA deposits, and HSA trusts receiving those deposits must restrict distributions to qualified medical debit‑card charges while federal payments are being made.
Requires Exchanges and issuers to disclose this option to prospective enrollees starting January 1, 2026, and makes the new rules apply to coverage months beginning after December 31, 2025. The section also sets out definitions, coordination rules, and implementation timing for the reimbursement and distribution limits.
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.
Introduced February 10, 2025 by W. Greg Steube · Last progress February 10, 2025