14. Department of Health and Human Services · Notable

Expand access to health savings accounts

Partially done

Printed page 470 14. Department of Health and Human Services

“CCIIO should also work with the Treasury Department and the Office of Management and Budget (OMB) to give consumers more flexibility with their health care dollars through expanded access to health savings accounts.”

What has happened

May 20, 2026 Partially done
CCIIO's own contribution: the 2027 Payment Notice finalizes an expanded hardship exemption that lets more people buy catastrophic coverage on the exchanges, which since Public Law 119-21 is HSA-qualified. Commenters in the rule note the pairing explicitly - "Congress recently made catastrophic plans eligible to be paired with health savings accounts (HSAs) without amending the statutory eligibility criteria for catastrophic coverage" - and note that the Health Care Freedom for Patients Act, which would have codified the September 2025 sub-regulatory guidance behind it, was not enacted in December 2025.
- CMS final rule: HHS Notice of Benefit and Payment Parameters for 2027 and Basic Health Program
  Primary Executive branch May 20, 2026
Jul 4, 2025 Partially done
Congress delivered three of the HSA expansions the Mandate wanted, though not through the CCIIO-Treasury-OMB route the Quote names. Public Law 119-21 section 71306 makes permanent the safe harbour letting high-deductible plans cover telehealth before the deductible; section 71307 makes bronze and catastrophic exchange plans HSA-qualified; section 71308 lets HSA holders pay direct primary care fees from the account without losing eligibility. The broader flexibility bills - Health Savings Accounts For All Act, Health Savings Account Expansion Act - are in committee, and Treasury and the IRS have published no implementing guidance.
- Public Law 119-21, sections 71306-71308 (telehealth safe harbor, bronze and catastrophic plans, direct primary care arrangements)
  Primary Congress Jul 4, 2025

Research log

What was searched, and what didn’t count as evidence

Research notes

Sections 71306-71308 read at https://www.govinfo.gov/content/pkg/PLAW-119publ21/html/PLAW-119publ21.htm; the 2027 Payment Notice catastrophic-coverage passages at https://www.govinfo.gov/content/pkg/FR-2026-05-20/html/2026-10050.htm.
Leveling: partial because the ask is open-ended (“more flexibility with their health care dollars through expanded access”) and delivery is incremental. A reviewer who reads the object as simply “expanded access to HSAs” would call it done on the statute alone.
#1288 owns the direct primary care limb of section 71308 and is done on its own narrower Quote.

Action: expand
Object: health savings accounts
ID: 1294