..................................................................... 

(Original Signature of Member) 

115

TH

CONGRESS 

1

ST

S

ESSION

 

H. R. ll 

To amend the Internal Revenue Code of 1986 to improve access to health 

care through expanded health savings accounts, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

Mr. P

AULSEN

introduced the following bill; which was referred to the 

Committee on llllllllllllll 

A BILL 

To amend the Internal Revenue Code of 1986 to improve 

access to health care through expanded health savings 

accounts, and for other purposes.

Be it enacted by the Senate and House of Representa-

1

tives of the United States of America in Congress assembled, 

2

SECTION 1. SHORT TITLE, ETC. 

3

(a) S

HORT

T

ITLE

.—This Act may be cited as the 

4

‘‘Health Savings Act of 2017’’. 

5

(b) A

MENDMENT OF

1986 C

ODE

.—Except as other-

6

wise expressly provided, whenever in this Act an amend-

7

ment or repeal is expressed in terms of an amendment 

8

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2

to, or repeal of, a section or other provision, the reference 

1

shall be considered to be made to a section or other provi-

2

sion of the Internal Revenue Code of 1986. 

3

(c) T

ABLE OF

C

ONTENTS

.—The table of contents is 

4

as follows:

5

Sec. 1. Short title, etc. 

TITLE I—RENAMING HIGH DEDUCTIBLE HEALTH PLANS 

Sec. 101. High deductible health plans renamed HSA-qualified health plans. 

TITLE II—ENHANCING ACCESS TO TAX-PREFERRED HEALTH 

ACCOUNTS 

Sec. 201. Allow both spouses to make catch-up contributions to the same HSA 

account. 

Sec. 202. Provisions relating to Medicare. 
Sec. 203. Individuals eligible for Indian Health Service assistance. 
Sec. 204. Members of health care sharing ministries eligible to establish health 

savings accounts. 

Sec. 205. Treatment of direct primary care service arrangements. 
Sec. 206. Individuals eligible for on-site medical clinic coverage. 
Sec. 207. Treatment of embedded deductibles. 

TITLE III—IMPROVING COVERAGE UNDER TAX-PREFERRED 

HEALTH ACCOUNTS 

Sec. 301. Allowance of distributions for prescription and over-the-counter medi-

cines and drugs. 

Sec. 302. Purchase of health insurance from HSA account. 
Sec. 303. Special rule for certain medical expenses incurred before establish-

ment of account. 

Sec. 304. Preventive care prescription drug clarification. 

TITLE IV—MISCELLANEOUS PROVISIONS RELATING TO TAX-

PREFERRED HEALTH ACCOUNTS 

Sec. 401. FSA and HRA interaction with HSAs. 
Sec. 402. Equivalent bankruptcy protections for health savings accounts as re-

tirement funds. 

Sec. 403. Administrative error correction before due date of return. 
Sec. 404. Reauthorization of Medicaid health opportunity accounts. 
Sec. 405. Maximum contribution limit to health savings account increased to 

amount of deductible and out-of-pocket limitation. 

TITLE V—OTHER PROVISIONS 

Sec. 501. Certain exercise equipment and physical fitness programs treated as 

medical care. 

Sec. 502. Certain nutritional and dietary supplements to be treated as medical 

care. 

Sec. 503. Certain provider fees to be treated as medical care.

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TITLE I—RENAMING HIGH 

1

DEDUCTIBLE HEALTH PLANS 

2

SEC. 101. HIGH DEDUCTIBLE HEALTH PLANS RENAMED 

3

HSA-QUALIFIED HEALTH PLANS. 

4

(a) I

N

G

ENERAL

.—Section 223 is amended by strik-

5

ing ‘‘high deductible health plan’’ each place it appears 

6

and inserting ‘‘HSA-qualified health plan’’. 

7

(b) C

ONFORMING

A

MENDMENTS

.—

8

(1) The heading for paragraph (2) of section 

9

223(c) is amended by striking ‘‘H

IGH DEDUCTIBLE

 

10

HEALTH

PLAN

’’ and inserting ‘‘HSA-

QUALIFIED

 

11

HEALTH PLAN

’’. 

12

(2) Section 408(d)(9) is amended—

13

(A) by striking ‘‘high deductible health 

14

plan’’ each place it appears in subparagraph 

15

(C) and inserting ‘‘HSA-qualified health plan’’, 

16

and 

17

(B) by striking ‘‘H

IGH

DEDUCTIBLE

 

18

HEALTH PLAN

’’ in the heading of subparagraph 

19

(D) and inserting ‘‘HSA-

QUALIFIED

HEALTH

 

20

PLAN

’’. 

21

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4

TITLE II—ENHANCING ACCESS 

1

TO TAX-PREFERRED HEALTH 

2

ACCOUNTS 

3

SEC. 201. ALLOW BOTH SPOUSES TO MAKE CATCH-UP CON-

4

TRIBUTIONS TO THE SAME HSA ACCOUNT. 

5

(a) I

N

G

ENERAL

.—Paragraph (5) of section 223(b) 

6

is amended to read as follows: 

7

‘‘(5) S

PECIAL RULE FOR MARRIED INDIVIDUALS

 

8

WITH FAMILY COVERAGE

.—

9

‘‘(A) I

N GENERAL

.—In the case of individ-

10

uals who are married to each other, if both 

11

spouses are eligible individuals and either 

12

spouse has family coverage under an HSA-

13

qualified health plan as of the first day of any 

14

month—

15

‘‘(i) the limitation under paragraph 

16

(1) shall be applied by not taking into ac-

17

count any other HSA-qualified health plan 

18

coverage of either spouse (and if such 

19

spouses both have family coverage under 

20

separate HSA-qualified health plans, only 

21

one such coverage shall be taken into ac-

22

count), 

23

‘‘(ii) such limitation (after application 

24

of clause (i)) shall be reduced by the ag-

25

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gregate amount paid to Archer MSAs of 

1

such spouses for the taxable year, and 

2

‘‘(iii) such limitation (after application 

3

of clauses (i) and (ii)) shall be divided 

4

equally between such spouses unless they 

5

agree on a different division. 

6

‘‘(B) T

REATMENT

OF

ADDITIONAL

CON

-

7

TRIBUTION AMOUNTS

.—If both spouses referred 

8

to in subparagraph (A) have attained age 55 

9

before the close of the taxable year, the limita-

10

tion referred to in subparagraph (A)(iii) which 

11

is subject to division between the spouses shall 

12

include the additional contribution amounts de-

13

termined under paragraph (3) for both spouses. 

14

In any other case, any additional contribution 

15

amount determined under paragraph (3) shall 

16

not be taken into account under subparagraph 

17

(A)(iii) and shall not be subject to division be-

18

tween the spouses.’’. 

19

(b) E

FFECTIVE

D

ATE

.—The amendment made by 

20

this section shall apply to taxable years beginning after 

21

the date of the enactment of this Act. 

22

SEC. 202. PROVISIONS RELATING TO MEDICARE. 

23

(a) I

NDIVIDUALS

O

VER

A

GE

65 O

NLY

E

NROLLED IN

 

24

M

EDICARE

P

ART

A.—Paragraph (7) of section 223(b) is 

25

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6

amended by adding at the end the following: ‘‘This para-

1

graph shall not apply to any individual during any period 

2

for which the individual’s only entitlement to such benefits 

3

is an entitlement to hospital insurance benefits under part 

4

A of title XVIII of such Act pursuant to an enrollment 

5

for such hospital insurance benefits under section 226(a) 

6

of such Act.’’. 

7

(b) M

EDICARE

B

ENEFICIARIES

P

ARTICIPATING IN

 

8

M

EDICARE

A

DVANTAGE

MSA M

AY

C

ONTRIBUTE

T

HEIR

 

9

O

WN

M

ONEY TO

T

HEIR

MSA.—

10

(1) I

N

GENERAL

.—Subsection (b) of section 

11

138 is amended by striking paragraph (2) and by re-

12

designating paragraphs (3) and (4) as paragraphs 

13

(2) and (3), respectively. 

14

(2) C

ONFORMING AMENDMENT

.—Paragraph (4) 

15

of section 138(c) is amended by striking ‘‘and para-

16

graph (2)’’. 

17

(c) E

FFECTIVE

D

ATE

.—The amendments made by 

18

this section shall apply to taxable years beginning after 

19

the date of the enactment of this Act. 

20

SEC. 203. INDIVIDUALS ELIGIBLE FOR INDIAN HEALTH 

21

SERVICE ASSISTANCE. 

22

(a) I

N

G

ENERAL

.—Paragraph (1) of section 223(c) 

23

is amended by adding at the end the following new sub-

24

paragraph: 

25

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7

‘‘(D) S

PECIAL RULE FOR INDIVIDUALS EL

-

1

IGIBLE

FOR

ASSISTANCE

UNDER

INDIAN

 

2

HEALTH SERVICE PROGRAMS

.—For purposes of 

3

subparagraph (A)(ii), an individual shall not be 

4

treated as covered under a health plan de-

5

scribed in such subparagraph merely because 

6

the individual receives hospital care or medical 

7

services under a medical care program of the 

8

Indian Health Service or of a tribal organiza-

9

tion.’’. 

10

(b) E

FFECTIVE

D

ATE

.—The amendment made by 

11

this section shall apply to taxable years beginning after 

12

the date of the enactment of this Act. 

13

SEC. 204. MEMBERS OF HEALTH CARE SHARING MIN-

14

ISTRIES ELIGIBLE TO ESTABLISH HEALTH 

15

SAVINGS ACCOUNTS. 

16

(a) I

N

G

ENERAL

.—Section 223 is amended by adding 

17

at the end the following new subsection: 

18

‘‘(i) A

PPLICATION TO

H

EALTH

C

ARE

S

HARING

M

IN

-

19

ISTRIES

.—For purposes of this section, membership in a 

20

health care sharing ministry (as defined in section 

21

5000A(d)(2)(B)(ii)) shall be treated as coverage under an 

22

HSA-qualified health plan.’’. 

23

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8

(b) E

FFECTIVE

D

ATE

.—The amendment made by 

1

this section shall apply to taxable years beginning after 

2

the date of the enactment of this Act. 

3

SEC. 205. TREATMENT OF DIRECT PRIMARY CARE SERVICE 

4

ARRANGEMENTS. 

5

(a) I

N

G

ENERAL

.—Section 223(c) is amended by 

6

adding at the end the following new paragraph: 

7

‘‘(6) T

REATMENT OF DIRECT PRIMARY CARE

 

8

SERVICE ARRANGEMENTS

.—An arrangement under 

9

which an individual is provided coverage restricted to 

10

primary care services in exchange for a fixed peri-

11

odic fee or payment for primary care services—

12

‘‘(A) shall not be treated as a health plan 

13

for purposes of paragraph (1)(A)(ii), and 

14

‘‘(B) shall not be treated as insurance for 

15

purposes of subsection (d)(2)(B).’’. 

16

(b) E

FFECTIVE

D

ATE

.—The amendment made by 

17

this section shall apply to taxable years beginning after 

18

the date of the enactment of this Act. 

19

SEC. 206. INDIVIDUALS ELIGIBLE FOR ON-SITE MEDICAL 

20

CLINIC COVERAGE. 

21

(a) I

N

G

ENERAL

.—Paragraph (1) of section 223(c), 

22

as amended by sections 203, is amended by adding at the 

23

end the following new subparagraph: 

24

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‘‘(E) S

PECIAL RULE FOR INDIVIDUALS EL

-

1

IGIBLE

FOR

ON

-

SITE

MEDICAL

CLINIC

COV

-

2

ERAGE

.—

3

‘‘(i) I

N GENERAL

.—For purposes of 

4

subparagraph (A)(ii), an individual shall 

5

not be treated as covered under a health 

6

plan described in such subparagraph mere-

7

ly because the individual is eligible to re-

8

ceive health care benefits from an onsite-

9

medical clinic of employer of the individual 

10

or the individual’s spouse if such health 

11

care benefits are not significant benefits. 

12

‘‘(ii) I

NCLUDED BENEFITS

.—For pur-

13

poses of clause (i), the following health 

14

care benefits shall be considered to be ben-

15

efits which are not significant benefits: 

16

‘‘(I) Physicals and immuniza-

17

tions. 

18

‘‘(II) Injecting antigens provided 

19

by employees. 

20

‘‘(III) Medications available with-

21

out a prescription, such as pain reliev-

22

ers and antihistamines. 

23

‘‘(IV) Treatment for injuries oc-

24

curring at the employer’s place of em-

25

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10

ployment or otherwise in the course of 

1

employment. 

2

‘‘(V) Tests for infectious diseases 

3

and conditions, such as streptococcal 

4

sore throat. 

5

‘‘(VI) Monitoring of chronic con-

6

ditions, such as diabetes. 

7

‘‘(VII) Drug testing. 

8

‘‘(VIII) Hearing or vision 

9

screenings and related services. 

10

‘‘(IX) Other services and treat-

11

ments of a similar nature to the serv-

12

ices described in subclauses (I) 

13

through (VIII). 

14

‘‘(iii) A

GGREGATION

RULES

.—For 

15

purposes of clause (i), all persons treated 

16

as a single employer under subsection (b), 

17

(c), (m), or (o) of section 414 shall be 

18

treated as a single employer.’’. 

19

(b) E

FFECTIVE

D

ATE

.—The amendment made by 

20

this section shall apply to taxable years beginning after 

21

the date of the enactment of this Act. 

22

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