As previously reported, efforts in Congress to "repeal and replace" the Affordable Care Act have halted pending the outcome of the upcoming midterm elections. As a result, Congress plans to focus on more-targeted health care reforms to address affordability, coverage and quality of care.
One issue that has garnered bipartisan support is improvements to health savings accounts (HSAs) to make health care more affordable. Earlier this week, U.S. Representative Mike Kelly (R-PA) introduced H.R. 5138, the Bipartisan HSA Improvement Act. Original co-sponsors of the bill include Representatives Earl Blumenauer (D-OR), Erik Paulsen (R-MN), Ron Kind (D-WI), Terri Sewell (D-AL) and Brian Fitzpatrick (R-PA). Similar bicameral legislation, S. 403 and H.R. 1175, the Health Savings Act, was introduced last year by Senate Finance Committee Chairman Orrin Hatch (R-UT), Senator Marco Rubio (R-FL), and House Ways and Means Committee member Paulsen.
Specifically, H.R. 5138 is designed to enhance HSAs to expand access, increase benefit flexibility, promote wellness and strengthen innovation. Among other provisions, the bill:
- Allows an employee to contribute to an HSA even if his or her spouse has a health flexible spending account;
- Permits the use of HSA dollars toward wellness benefits, including exercise and other expenses associated with physical activity;
- Clarifies that employers can offer "excepted benefits" like telehealth and second opinion services to employees with an HSA plan;
- Allows HSA plans to offer pre-deductible coverage for services and medications designed to manage chronic conditions; and
- Makes technical changes to correct the definition of "dependents" to include children up to age 26 and fix the prohibition on a spouse using an HSA.
The proposal is supported by SHRM and other groups within the employer community. In an effort to expedite consideration of the measure, the bill's sponsors plan to attach this proposal to the fiscal 2018 Omnibus federal spending bill, which Congress must take up by March 23. SHRM and the employer community sent a letter to Senate leadership urging support for HSA improvements in the omnibus spending bill.
As Congress considers health care modifications, SHRM will continue to advocate in support of proposals that will strengthen and support the employer-sponsored system.