HR-548-119
Referred to the House Committee on Ways and Means.
Sponsored by Beth Van Duyne (R-TX)
What it does
This bill would roughly double the annual contribution limits for Health Savings Accounts (HSAs), raising the 2025 self-only cap from $4,300 to $8,300 and the family cap from $8,550 to $16,600, tied going forward to out-of-pocket expense limits under high-deductible health plans (HDHPs). It would expand eligibility to include VA healthcare recipients without service-connected disabilities, Indian Health Service patients, Medicare Part A enrollees aged 65+, and people with bronze-level or catastrophic exchange plans. It would also allow HSA funds to cover expenses incurred up to 60 days before the account is opened, permit distributions for long-term care services, allow married couples to pool catch-up contributions into one HSA, and require HDHPs to cover up to $500 in mental health benefits before the deductible is met.
Who benefits
Current HSA holders who could shelter more income from taxes — particularly higher-income individuals with the financial capacity to maximize contributions. Veterans receiving VA care without service-connected disabilities, who are currently ineligible. Native Americans receiving care through the Indian Health Service or tribal organizations. Medicare Part A enrollees aged 65+ who are currently barred from contributing. People enrolled in bronze-level or catastrophic exchange plans. Married couples who could consolidate catch-up contributions. Individuals with long-term care needs. People with mental health conditions who would gain pre-deductible coverage. Financial institutions and HSA administrators who would manage larger account balances. Employers who offer HDHPs and could attract workers with enhanced HSA benefits.
Who is hurt
The federal government would forgo tax revenue on the expanded contributions, potentially shifting costs to other taxpayers or increasing the deficit. Lower-income workers who cannot afford to maximize even current HSA limits would see little direct benefit, potentially widening the gap between those who can and cannot use tax-advantaged accounts. Traditional comprehensive health insurance plans and their enrollees could face competitive disadvantage if HDHPs become more attractive. Insurers offering HDHPs would be required to cover mental health benefits pre-deductible, which may increase premiums. Taxpayers broadly, if the revenue loss is not offset.
Supporters argue
Supporters argue that current HSA contribution limits are far below actual out-of-pocket maximums — leaving families exposed to thousands of dollars in unshielded medical costs — and that doubling the limits aligns tax-advantaged savings with real healthcare expenses. They contend that expanding eligibility to VA patients, IHS recipients, Medicare Part A enrollees, and bronze-plan holders removes arbitrary exclusions that leave millions of Americans unable to use a tool available to others with similar healthcare needs. They also argue that allowing pre-deductible mental health coverage addresses a documented gap in behavioral health access under HDHPs.
Opponents argue
Opponents argue that HSA tax benefits are structurally regressive — the Tax Policy Center and similar analyses show that the top income quintile captures a disproportionate share of HSA tax savings, meaning doubling contribution limits would primarily benefit high earners who can afford to maximize them. They contend that expanding HDHPs and HSAs shifts financial risk onto patients, and that evidence from the health economics literature suggests high-deductible plans cause some enrollees to delay or forgo necessary care due to cost. They also argue that the revenue loss from expanded limits would add to the federal deficit without a clear offset mechanism.
Constitutional context
This bill falls squarely within Congress's taxing and spending power under Article I, §8, cl. 1, which grants broad authority to impose and modify taxes, including tax exclusions and deductions. No significant constitutional tension is present; HSA contribution limits are a straightforward modification of existing tax code provisions, and the Sixteenth Amendment provides ample authority for income-based tax treatment of savings accounts.
Checks and balances
Congress gains authority to define the scope of tax-advantaged savings; the IRS implements and enforces contribution limits and eligibility rules, and courts retain jurisdiction to review any disputes over eligibility determinations or regulatory interpretations.
Historical precedent
The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 created HSAs, and Congress has periodically adjusted contribution limits and eligibility rules since then, though no prior bill has proposed doubling the limits in a single action.