Health Marketplace and Savings Accounts for All Act

Summary

Changes how Health Savings Account (HSA) contribution limits and catch-up amounts are set by tying them to other indexed dollar amounts in the tax code, updates many cross-references and reporting rules, and makes those tax changes effective for taxable years beginning after enactment. It also creates a new legal structure that lets specially qualified “health marketplace pools” operate like employers only for the purpose of offering group health plans or group health insurance, with rules on membership, nondiscrimination, allowable benefits (including drug-only plans and over-the-counter drugs), contracting, and enrollment. The bill affects taxpayers who use HSAs, employers and plan administrators who report or maintain HSA and group plan records, insurers and third-party administrators that contract with new pools, and people without employer coverage who might gain access to pooled group plans. It requires updates to plan documents, payroll and tax reporting, and creates new regulatory constructs under ERISA for pools offering coverage.

• HSA contribution limits will be set by reference to another indexed dollar amount in the tax code, changing how annual limits move with inflation.
• The separate age‑50+ HSA catch‑up increase is restored and tied to its own indexed amount.
• Multiple HSA subsections are redesignated and many tax-code cross-references are updated, affecting reporting and plan documentation.
• Individuals can deduct cash HSA contributions made during the taxable year (clarified deduction rule).
• A new federal statutory framework treats qualifying "health marketplace pools" as employers only for the limited purpose of offering group health plans or insurance coverage under ERISA.
• Pools may contract with insurers or self-insure, provide administrative services, and offer varied benefit designs including drug-only and over-the-counter drug coverage.
• Participation in a pool does not create employer or joint-employer status except for offering coverage, and membership is carved out from certain fiduciary status rules.
• The HSA tax changes apply to taxable years beginning after enactment; the pool rules take effect on enactment unless otherwise specified.
• Plan sponsors, trustees, insurers, and payroll/reporting systems must update documents and processes to reflect the new technical tax and ERISA rules.