House passes bills to expand HSAs, delay health insurance tax

The House of Representatives passed a pair of bills on Wednesday that would loosen regulations around health savings accounts and delay the health insurance tax for two years.

The Restoring Access to Medication and Modernizing Health Savings Accounts Act (H.R. 6199) passed 277-142. The legislation would give plans additional flexibility to cover services before a deductible is met. It would also permit spouses to contribute to an HSA and allow members to purchase over-the-counter drugs.

The Increasing Access to Lower Premium Plans and Expanding Health Savings Accounts Act of 2018 (H.R. 6311), which passed 242-176, would increase the amount beneficiaries can contribute to an HSA. But it also includes provisions to add catastrophic or “copper” plans to the ACA exchanges.

“Additional solutions to strengthen Health Savings Accounts will provide Americans with more choices, more control and better flexibility to invest their healthcare dollars in ways that best fit their personal needs,” AHIP president and CEO Matt Eyles said in a statement.

H.R. 6311 also includes a two-year delay on the health insurance tax, something insurers have pushed against for some time. In an earnings call last week, UnitedHealth Group CEO David Wichmann said the insurer was advocating for a “delay or outright repeal of the insurance tax” which he claimed would drive up premiums.

In 2015, the most recent year the tax was in effect, insurers lost about $11 billion.

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“Providing another temporary reprieve, as work continues to fully repeal this harmful tax, will help reduce premiums for families, small business owners, seniors and states,” Eyles said.

HSAs have been largely supported by Republicans, although some bipartisan bills have sought to use high-deductible plans and HSAs to improve chronic disease treatment. HSAs combined with high-deductible plans have seen steady growth over the last several years, increasing more than 400% since 2007, according to AHIP.

Critics have pointed out that HSAs don’t work well for low-income individuals who don’t have the money to put into an HSA.

On Thursday, following a speech at the Heritage Foundation, Department of Health and Human Services Secretary Alex Azar lauded the use of HSAs as a way to involve consumers in their care.

“We are very supportive of efforts to strengthen HSAs to allow more money to be put in there, to enable the HSA money to be used for more preventive services, and to expand the reach of those,” he said. “I think it’s a critical counterpart to high-deductible plans and a critical element to how we bring that kind of consumerism to a third-party payer system.”