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bill Progress


  • Not enacted
    The President has not signed this bill
  • The senate has not voted
  • The house Passed July 25th, 2018
    Roll Call Vote 242 Yea / 176 Nay
      house Committees
      House Committee on Ways and Means
      House Committee on Energy and Commerce
    IntroducedJuly 6th, 2018

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What is it?

This bill — the Increasing Access to Lower Premium Plans and Expanding Health Savings Accounts Act — would aim to make it easier for Americans to access lower premium health insurance plans by letting them be paid for using premium tax credits, while expanding Health Savings Accounts (HSAs) and similar arrangements. It contains the legislative text of five related bills which passed the House Ways and Means Committee, summaries of which can be found below.

Increasing Access to Lower Premium Plans Act: This section of the bill would reform the Affordable Care Act (commonly known as Obamacare) to allow premium tax credits to be used for qualified plans offered outside of the law’s exchanges and Healthcare.gov. It’d also allow the premium tax credit to be used for catastrophic (or “copper”) insurance plans. Additionally, all participants in the individual marketplace could purchase such plans, which are limited to people under age 30 under current law.

Responsible Additions and Increases to Sustain Employee Health Benefits Act: This section of the bill would allow unused balances or a portion of the balance in health flexible spending accounts (FSAs) to be carried forward into the next plan year. Current law requires that all balances be used by the end of the plan year or else they’re forfeited.

Health Savings Act: This section of the bill would expand eligibility and access to HSAs by allowing plans categorized as “catastrophic” and “bronze” in the exchanges to qualify for HSA contributions.

Improve the Rules with Respect to Health Savings Accounts: This section of the bill would increase contribution limits for HSAs by allowing both spouses to contribute to make catch-up contributions to the same account. It’d also make HSAs more flexibility by creating a new 60-day grace period for medical expenses incurred before the HSA was established.

Allowing Working Seniors to Keep Their Health Savings Accounts Act: This section of the bill would make seniors who are still in the workforce eligible to access HSAs. Current law prohibits Medicare beneficiaries from having a secondary payer or an HSA.

Impact

Americans purchasing health insurance; seniors in the workforce; users of HSAs and FSAs; and the IRS.

Cost

A CBO cost estimate is unavailable.

More Information

In-Depth: The Increasing Access to Lower Premium Plans Act passed the committee on a 23-16 vote. Sponsoring Rep. Peter Roskam (R-IL) said of his bill:

“The bill… provides a much-needed off-ramp for the pressure that people are feeling right now in terms of premium increases and limited choices by allowing the tax credits to be used for qualified plans offered outside of the law’s exchange and healthcare.gov.”

House Democrats opposed the bill, saying it’d continue “Republican efforts to undermine and destabilize the health insurance market” in addition to increasing costs and undermining women’s healthcare.

The Responsible Additions and Increases to Sustain Employee Health Benefits Act passed the committee on a 22-14 vote with the support of 6 bipartisan cosponsors. One of those cosponsors, Rep. Jackie Walorski (R-IN) said “by allowing [patients] to rollover their unused [FSA] funds it will incentivize consumers to only purchase what they need, ensuring more economic efficiency in the health care system.” Some House Democrats opposed the bill because it “does not undo sabotage, premium hikes, and benefit cuts Republicans have caused over the past 18 months.”

The Health Savings Act passed the committee on a 23-13 vote, with original cosponsor Rep. Peter Roskam (R-IL) saying “it’s a powerful fix that helps drive consumer choice and flexibility as individuals select the coverage that’s best suited to their needs.” Some Democrats opposed the bill, saying “HSAs mostly benefit high-income taxpayers while doing little to help moderate-income families or the uninsured.”

The Improve the Rules with Respect to Health Savings Accounts Act passed the committee on a 22-16 vote, with sponsoring Rep. Erik Paulsen (R-MN) saying:

“The bottom line is we’re improving the rules for HSA account holders to allow them to contribute more, catch up contributions with their spouse, and pay older medical bills out of a HSA account: improvements that make sense.”

House Democrats opposed the bill, writing that “HSAs mostly benefit high-income taxpayers while doing little to help moderate-income families or the uninsured.”

The Allowing Working Seniors to Keep Their Health Savings Accounts Act passed the committee on a 23-16 vote, with sponsoring Rep. Erik Paulsen (R-MN) saying:

“We should be encouraging… these folks to stay in the workforce — especially now in a time when we have more job openings than jobs seekers and a lot of folks want to be able to continue to work. This is simply another choice that will, ironically, save Medicare money. Save Medicare money because individuals will now use their own health care dollars to pay for services rather than relying on Medicare and straining that program any further.”

House Democrats opposed this bill, saying it “does nothing to undo Republican attacks on Medicare” and that “as a result of the Republican tax bill, the Medicare Trust Fund’s solvency has been slashed by three years.”


Media:

Summary by Eric Revell

(Photo Credit: iStock / gerenme)

AKA

Increasing Access to Lower Premium Plans and Expanding Health Savings Accounts Act of 2018

Official Title

To amend the Internal Revenue Code of 1986 and the Patient Protection and Affordable Care Act to modify the definition of qualified health plan for purposes of the health insurance premium tax credit and to allow individuals purchasing health insurance in the individual market to purchase a lower premium copper plan.

    Comments are all over the board again. And with many, it’s very obvious that they have not read the legislation, nor do they have even a basic understanding of health savings accounts. Even the Democrat opposition listed show their ignorance. But for the most part...1) This is somewhat bi-partisan, 2) Just because it doesn’t include birth-control—which I think it should, because a person is spending money from their own account and it is not funded by an employer—that an individual can use it for over-the-counter drugs may help prevent a more expensive trip to the physician (pregnancy or flu), 3) It will allow for gym fees to be included which works toward prevention, 4) Health Savings Accounts are not only for the rich. Many employers offer these, 5) Health Savings accounts allow people to put pre-taxed income in an account to use for healthcare, and allow for flexibility for those CHOOSING to use one, 6) These accounts will not drive up healthcare costs, but provide one more option to pay for the things that may help someone to stay healthy so they don’t have to run off to the doctor for every sniffle, for high blood pressure or pre-diabetes related illnesses, all which can be prevented with exercise. I say vote, “yeah,” on this legislation.
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    Single payer healthcare now! The ACA does nowhere near enough to help Americans. This bill favors wealthy Americans. Keep the ACA intact or replace it with Medicare for all.
    Like (75)
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    Single payer healthcare system is really the best move forward for healthcare in America.
    Like (40)
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    No, under the guise of increased consumer flexibility, this bill would start the slippery slope back down to where we were before. The paltry protections they give are not worth the money they cost. Please vote no.
    Like (34)
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    Yes to self-sufficiency. Yes to keeping more of your own money. Yes to increased HSA allowances.
    Like (20)
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    Those of you screaming for single payer healthcare must not care about quality healthcare. The government has no business meddling in our healthcare. Our government runs the VA. Look how well that has worked out for our veterans. Not so well. We need competition among insurance companies. If we could buy insurance crossing state lines, our premiums would definitely drop.
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    WHAT crap is this? Just another way for the 1% to become richer and the 99% to get screwed.
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    Health Savings Accounts (HSA) are a No-Brainer! Young people can become healthcare independent by retirement age as a result of having an HSA during their working life.
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    The devil in the details.
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    No. It would raise the premiums for those who do not have insurance and look to get their insurance through the ACA. These low cost plans are garbage plans. I know of people who have has the HSA plans and if you have chronic conditions such as asthma, you will run out of money to pay for your healthcare and prescriptions. We need single payer.
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    THIS BILL IS JUST ANOTHER WAY TO TAKE ADVANTAGE OF THE POOR WITH BAD HEALTH PLANS THAT WILL COST THEM MORE THAN THEY CAN EVER RECOVER FROM IT EVEN IF THEY GET A SERIOUS ILLNESS, WHICH IT WILL MOSTLY NOT COVER! THIS IS JUST ANOTHER REPUBLICAN WAY TO MAKE MONEY FROM THE MISERY OF THE POOR AND TAKE ADVANTAGE OF THEM! THIS IS WHY WE NEED MEDICARE FOR ALL, JUST AS ALL OF THE OTHER COUNTRIES IN THE DEVELOPED WORLD HAVE HAD FOR DECADES! YOU REPUBLICANS NEVER DO ANYTHING UNLESS YOU CAN MAKE MONEY FROM IT! SHAME ON YOU FOR BEING SO UNCHRISTIAN AND UNAMERICAN!
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    The very essence of insurance is to spread the total cost to everyone so no one is stuck with high premiums because they are sick. This destroys that model by letting healthy people purchase small plans. Stop the madness and stop destroying healthcare in America!
    Like (7)
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    Yes,Yes, Yes!!! This bill would expand consumers’ choices in the healthcare market by allowing all to purchase the health insurance plans with premium assistance tax credits while making changes to make Health Savings Accounts more useful to all Americans.
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    I have used FSA’s they are not for the wealthy you get them through your work as part of their medical plan. They enable you to set aside money before taxes that you can use for dental procedures health bills or hearing aids and prescription drugs
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    We need FSAs even if your employer does not offer them and for people on Medicare as a way to save their maximum yearly possible expenditure.
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    No this is just another bill that will decrease the availability of good health insurance for the American people and help the rich avoid taxes while decreasing coverage for the poorest among us.
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    Medicare for all is the only fair way to go.
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    Just another misleading effort by Republicans to dismantle the ACA.
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    All this does is encourage Americans to buy cheap policies that are essentially useless to them. The government should be working more on ways to drive down the cost of healthcare overall and reducing insurance premiums.
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    These insurance plans cover less have higher deductibles and destabilise the insurance industry for sick older people who need insurance most.
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