Protecting Life in Health Savings Accounts Act

Summary

Prohibits the use of tax-advantaged health accounts and tax-free reimbursements to pay for abortions except in narrow cases of rape, incest, or certified physical health threats (including life‑endangering conditions caused by pregnancy). The change applies to Health Savings Accounts, Archer MSAs, health Flexible Spending Accounts, Health Reimbursement Arrangements, and certain retiree health accounts for taxable years beginning after December 31, 2025.

• Prohibits use of HSAs, Archer MSAs, FSAs, HRAs, and certain retiree health accounts to pay for abortions except for rape, incest, or certified physical health threats.
• Applies through changes to the Internal Revenue Code governing tax-advantaged medical accounts and reimbursements.
• Effective for taxable years beginning after December 31, 2025; FSA/HRA changes apply to expenses incurred in those taxable years.
• Exceptions require certification of rape, incest, or a physical disorder/injury/illness (including life‑endangering pregnancy conditions).
• Employers and plan administrators must change plan documents and reimbursement procedures to comply.
• Individuals who obtain abortions outside the exceptions will face higher out-of-pocket costs because tax-advantaged funds cannot be used.
• Enforcement is through tax treatment: excluded payments lose tax-advantaged or tax-free reimbursement status.
• Could create additional administrative and documentation burdens for patients and providers seeking exception certification.