Bill · S. 4353· Senate(119-S-4353)
Health Savings Account Expansion Act
- Introduced
- 4/21/2026
- Last activity
- 4/21/2026 — Read twice and referred to the Committee on Finance.
- Sponsored by
- Roger Marshall
- Cosponsors
- None
- Introduced
- In Committee
What this bill would do
The Health Savings Account Expansion Act aims to amend the Internal Revenue Code of 1986 to expand eligibility for health savings accounts. It modifies eligibility requirements to include individuals covered under government plans like Medicare, Medicaid, and CHIP, as well as participants in health care sharing ministries. The bill also updates high deductible health plan requirements and allows for payments from HSAs for specific health plans or insurance coverage. Additionally, it expands the definition of qualified medical expenses to include certain medical care service arrangements. The Act also modifies how over-the-counter drugs and insulin are treated for HSAs and Archer MSAs. These changes are generally set to take effect for taxable years beginning after December 31, 2026.
Yes· 3 of 10
Would people over 65 be better off under this?+4
The bill allows Medicare beneficiaries to access the tax-advantaged benefits of Health Savings Accounts.
Does this make health care easier to get in general?+4
The bill expands the ability to use HSAs for insurance premiums, periodic physician fees, and wellness services.
Would households on low incomes be better off under this?+3
The bill extends HSA eligibility to those covered by government assistance programs like Medicaid and CHIP.
The opposite
No question was scored the opposite.
Who it would affect, and how
Potential Positive Impacts for People
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Expanded HSA Eligibility: Individuals covered under government plans—including Medicare (Parts A, B, or C), Medicaid, CHIP, or certain other coverage—and participants in health care sharing ministries would be eligible for health savings accounts (Section 2 of the bill).
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Expanded Use of HSA Funds for Insurance: The bill allows for payments from HSAs for certain health plans or insurance coverage (Section 4).
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Broadened Medical Expenses: The definition of "qualified medical expenses" would be expanded to include periodic fees paid to a physician for defined services or the right to receive services on an as-needed basis, as well as amounts prepaid for services intended to screen, diagnose, cure, mitigate, treat, prevent disease, or promote wellness (Section 4).
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Treatment of Sharing Ministry Expenses: For those involved in health care sharing ministries, membership fees, the sharing of medical expenses among members, and administrative fees would be treated as amounts paid for medical care (Section 6).
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Expanded Drug Coverage: The term "medicine or a drug" for HSAs and Archer MSAs would include prescribed drugs (regardless of whether they are available without a prescription) and insulin (Section 7).
Potential Negative Impacts for People
- No specific negative impacts are explicitly detailed in the provided text.
Groups and Interests Ranking
Every group the model scored this bill for, from -10 to +10. Hover a score for the reason it gave.
- Demographic And Interest Groups
- Good For Seniors+4Good For Low Income Households+3Good For Middle Class Households+3Good For People With Disabilities+2
- Healthcare
- Improves Healthcare Access+4Reduces Prescription Drug Costs+3Increases Medicaid Funding+2Increases Medicare Funding+2
- Economy And Finance
- Reduces Middle Class Taxes+3
- Social Issues And Justice
- Improves Poverty Reduction+2
- 4/21/2026
- Read twice and referred to the Committee on Finance.
- Introduced in Senate