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Prohibits tax‑advantaged health accounts from covering abortions except in limited cases. It would bar use of Health Savings Accounts (HSAs), Archer MSAs, flexible spending accounts (FSAs), health reimbursement arrangements (HRAs), and related retiree health accounts to pay for abortions unless the procedure is for rape, incest, or to save the life of the pregnant person. The change is implemented by amending the Internal Revenue Code and becomes effective for taxable years beginning after December 31, 2025, with the reimbursement prohibition applying to expenses incurred in those taxable years.
The bill stops most elective abortions from being paid with tax-advantaged health accounts—reducing taxpayer subsidy and aligning with some taxpayers' preferences—but shifts costs onto women (especially low-income), employees and retirees, employers/plan administrators, and health providers while creating modest fiscal and administrative effects.
Most taxpayers will no longer subsidize elective abortions through tax-advantaged health accounts and retiree health funds, reducing tax-preferred spending on those procedures.
The change aligns federal tax treatment with the preferences of taxpayers who object to subsidizing elective abortions, reducing perceived moral or political subsidies.
By excluding elective abortions from pre-tax accounts, the policy may modestly reduce tax expenditures or increase federal tax receipts relative to current law (small fiscal benefit).
Women seeking elective abortions (except for rape/incest or when the pregnancy endangers the woman's life), especially low-income women, will lose the ability to use pre-tax HSA/FSA/HRA/Archer MSA or retiree health funds and thus face higher out-of-pocket costs.
Low-income patients will be disproportionately harmed because they are less able to pay cash for abortions that lose tax-advantaged coverage, worsening disparities in access to reproductive care.
Employees and retirees who relied on employer FSAs/HRAs or retiree health accounts for reproductive care will experience reduced benefits and increased personal spending to obtain abortions.
Introduced January 24, 2025 by Mike Lee · Last progress January 24, 2025