,i  #aae? ,,congress  #b;d ,session  ,h4
 ,r4 #each  ,,9 ,,! ,,h\se ,,(          
,,repres5tatives  ,m>* #a1 #bjah,mr4    
,kelly ( ,p5nsylvania 7= himself1 ,mr4  
,blum5au]1 ,mr4 ,pauls51 ,mr4 ,k9d1 ,ms4
 ,sewell ( ,alabama1 & ,mr4             
,fitzpatrick7 introduc$ ! foll[+ bill2  
:i* 0 ref]r$ to ! ,committee on ,ways & 
,means  ,a ,,bill  ,to am5d ! ,int]nal  
,rev5ue ,code ( #aihf to improve access 
to heal? c>e ?r\gh mod]niz$ heal? sav+s 
acc\nts4  #a4 ,%ort title ,?is ,act may 
be cit$ z ! ,bip>tisan ,,hsa ,improvem5t
 ,act ( #bjah4  #b4 ,except$ b5efits    
all[$ z p]mitt$ insurance  7a7 ,9 g5]al 
,p>agraph 7#c7 ( section #bbc7;c7 ( !   
,int]nal ,rev5ue ,code ( #aihf is       
am5d$--  7#a7 by r$esignat+ subp>agraphs
 7,b7 & 7,c7 z subp>agraphs 7,c7 & 7,d71
 respectively2 &  7#b7 by ins]t+ !      
foll[+ new subp>agraph3  7,b7 insurance 
consi/+ ( cov]age = any except$ b5efits 
describ$ 9 section #ihcb7;c71  4  7b7   
,effective date ,! am5dm5ts made by ?is 
section %all apply to taxable ye>s aft] 

! date ( ! enactm5t ( ?is ,act4  #c4    
,on-site employee cl9ics & retail cl9ics
  7a7 ,9 g5]al ,p>agraph 7#a7 ( section 
#bbc7;c7 ( ! ,int]nal ,rev5ue ,code (   
#aihf is am5d$ by add+ at ! end ! foll[+
 new subp>agraph3  7,d7 ,special rule = 
qualifi$ items & s]vices  7i7 ,9 g5]al  
,= purposes ( subp>agraph 7,a77ii71 an  
individual %all n be treat$ z cov]$ "u a
 heal? plan = purposes ( subp>agraph    
7,a77ii7 m]ely because ! individual is  
eligible to receive1 or receives1       
qualifi$ items & s]vices at--  7,i7 a   
heal?c>e facility locat$ at a facility  
own$ or leas$ by ! employ] ( !          
individual 7or ( ! individual's sp\se71 
or op]at$ prim>ily = ! b5efit ( su*     
employ]'s employees1 or  7,,ii7 a retail
 heal? cl9ic4  7ii7 ,qualifi$ items &   
s]vices def9$ ,= purposes ( ?is         
subp>agraph1 ! t]m qualifi$ items &     
s]vices means ! foll[+3  7,i7 ,prim>y   
c>e includ+ physical exam9ation4  7,,ii7
 ,immunizations1 includ+ injections (   
antig5s provid$ by employees4  7,,iii7  

,drugs or biologicals o!r ?an a         
prescrib$ drug 7z su* t]m is def9$ 9    
section #bac7;d77#c774  7,,iv7 ,treatm5t
 = injuries occurr+ 9 ! c\rse (         
employm5t4  7,v7 ,te/s = conditions or  
infecti\s diseases4  7,,vi7 ,managem5t (
 m$ically complex *ronic conditions4    
7,,vii7 ,drug te/+4  7,,viii7 ,he>+ or  
vision scre5+s & relat$ s]vices4  7,,ix7
 ,o!r simil> items & s]vices4  7iii7    
,retail heal? cl9ic def9$ ,= purposes ( 
?is subp>agraph1 ! t]m retail heal?     
cl9ic means a heal? c>e facility locat$ 
)9 a sup]m>ket1 ph>macy1 or simil>      
retail e/abli%m5t t (f]s urg5t c>e by a 
lic5s$ heal?c>e provid]4  7iv7          
,aggregation ,= purposes ( clause 7i71  
all p]sons treat$ z a s+le employ] "u   
subsection 7b71 7c71 7m71 or 7o7 (      
section #dad %all be treat$ z a s+le    
employ]4  4  7b7 ,effective date ,!     
am5dm5ts made by ?is section %all apply 
to mon?s 9 taxable ye>s beg9n+ aft] !   
date ( enactm5t ( ?is ,act4  #d4        
,contributions p]mitt$ if sp\se has a   

heal? flexible sp5d+ acc\nt  7a7        
,contributions p]mitt$ if sp\se has a   
heal? flexible sp5d+ acc\nt ,subp>agraph
 7,b7 ( section #bbc7;c77#a7 ( !        
,int]nal ,rev5ue ,code ( #aihf is am5d$ 
by /rik+ & at ! end ( clause 7ii71 by   
/rik+ ! p]iod at ! end ( clause 7iii7 & 
ins]t+ 1 &1 & by ins]t+ aft] clause     
7iii7 ! foll[+3  7iv7 cov]age "u a heal?
 flexible sp5d+ arrangem5t ( ! sp\se ( !
 individual4  4  7b7 ,effective date ,! 
am5dm5t made by ?is section %all apply  
to taxable ye>s beg9n+ aft] ! date ( !  
enactm5t ( ?is ,act4  #e4 ,dep5d5ts to  
include *ildr5 up to age #bf  7a7 ,9    
g5]al ,subp>agraph 7,a7 ( section       
#bbc7;d77#b7 ( ! ,int]nal ,rev5ue ,code 
( #aihf is am5d$ by /rik+ & any dep5d5t 
7z def9$ 9 section #aeb1 det]m9$ )\t    
reg>d to subsections 7b77#a71 7b77#b71 &
 7d77#a77;,b7 !re(7 ( su* individual 9  
subp>agraph 7,a7 & ins]t+ any dep5d5t 7z
 def9$ 9 section #aeb1 det]m9$ )\t reg>d
 to subsections 7b77#a71 7b77#b71 &     
7d77#a77;,b7 !re(7 ( su* individual1 &  

any *ild 7z def9$ 9 section             
#aeb7;f77,a77 ( su* individual :o has n 
atta9$ ! age ( #bg be=e ! end ( su*     
individual's taxable ye>4  7b7          
,effective date ,! am5dm5ts made by ?is 
section %all apply ) respect to qualifi$
 m$ical exp5ses incurr$ 9 taxable ye>s  
beg9n+ aft] ! date ( ! enactm5t ( ?is   
,act4  #f4 ,,fsa & ,,hra int]action )   
,h,s,as  7a7 ,eligible individuals      
include ,,fsa & ,,hra p>ticipants       
,subp>agraph 7,b7 ( section #bbc7;c77#a7
 ( ! ,int]nal ,rev5ue ,code ( #aihf1 z  
am5d$ by ?is ,act1 is am5d$ by /rik+ &  
at ! end ( clause 7iii71 by /rik+ !     
p]iod at ! end ( clause 7iv7 & ins]t+ 1 
&1 & by ins]t+ aft] clause 7iv7 ! foll[+
 new clause3  7v7 cov]age "u a heal?    
flexible sp5d+ arrangem5t or a heal?    
reimbursem5t arrangem5t 9 ! plan ye> a  
qualifi$ ,,hsa di/ribution z describ$ 9 
section #ajf7;e7 is made on behalf ( !  
individual if1 aft] ! qualifi$ ,,hsa    
di/ribution is made & = ! rema9+        
duration ( ! plan ye>1 ! cov]age provid$

 "u ! arrangem5t is conv]t$ solely to "o
 or m ( ! foll[+3  7,i7 ,po/-d$uctible  
,,fsa or ,,hra ,a heal? flexible sp5d+  
arrangem5t or a heal? reimbursem5t      
arrangem5t t does n pay or reimburse any
 m$ical exp5se incurr$ be=e ! m9imum    
annual d$uctible "u p>agraph            
7#b77;,a77i7 7prorat$ = ! p]iod occurr+ 
aft] ! qualifi$ ,,hsa di/ribution is    
made7 is satisfi$4  7,,ii7 ,prev5tative 
c>e ,a heal? flexible sp5d+ arrangem5t  
or a heal? reimbursem5t arrangem5t t1   
aft] ! qualifi$ ,,hsa di/ribution is    
made1 does n pay or reimburse any m$ical
 exp5se incurr$ aft] ! qualifi$ ,,hsa   
di/ribution is made o!r ?an prev5tive   
c>e z def9$ 9 p>agraph 7#b77;,c74       
7,,iii7 ,limit$ purpose heal? ,,fsa ,a  
heal? flexible sp5d+ arrangem5t t1 aft] 
! qualifi$ ,,hsa di/ribution is made1   
pays or reimburses b5efits = cov]age    
describ$ 9 clause 7ii7 7b n ?r\gh       
insurance or = long-t]m c>e s]vices74   
7,,iv7 ,limit$ purpose ,,hra ,a heal?   
reimbursem5t arrangem5t t1 aft] !       

qualifi$ ,,hsa di/ribution is made1 pays
 or reimburses b5efits = p]mitt$        
insurance or cov]age describ$ 9 clause  
7ii7 7b n = long-t]m c>e s]vices74  7,v7
 ,retirem5t ,,hra ,a heal? reimbursem5t 
arrangem5t t1 aft] ! qualifi$ ,,hsa     
di/ribution is made1 pays or reimburses 
only ^? m$ical exp5ses incurr$ aft] an  
individual's retirem5t 7& no exp5ses    
incurr$ be=e retirem5t74  7,,vi7        
,susp5d$ ,,hra ,a heal? reimbursem5t    
arrangem5t t1 aft] ! qualifi$ ,,hsa     
di/ribution is made1 is susp5d$1        
pursuant to an election made on or be=e 
! date ! individual elects a qualifi$   
,,hsa di/ribution or1 if lat]1 on ! date
 ( ! individual enrolls 9 an            
,,hsa-qualifi$ heal? plan1 t does n pay 
or reimburse1 at any "t1 any m$ical     
exp5se incurr$ dur+ ! susp5sion p]iod   
except z describ$ 9 ! prec$+ subclauses 
( ?is clause4  4  7b7 ,qualifi$ ,,hsa   
di/ribution %all n affect flexible sp5d+
 arrangem5t ,p>agraph 7#a7 ( section    
#ajf7;e7 ( su* ,code is am5d$ to read z 

foll[s3  7#a7 ,9 g5]al ,a plan %all n   
fail to be treat$ z--  7,a7 a heal?     
flexible sp5d+ arrangem5t "u ?is        
section1 section #aje1 or section #abe1 
7,b7 a heal? reimbursem5t arrangem5t "u 
?is section or section #aje1 or  7,c7 an
 accid5t or heal? plan1  m]ely because  
su* plan provides = a qualifi$ ,,hsa    
di/ribution4  4  7c7 ,,fsa balances at  
ye> end %all n =feit ,p>agraph 7#b7 (   
section #abe7;d7 ( su* ,code is am5d$ by
 add+ at ! end ! foll[+ new subp>agraph3
  7,e7 ,exception = qualifi$ ,,hsa      
di/ributions ,subp>agraph 7,a7 %all n   
apply to ! ext5t t !re is an am\nt      
rema9+ 9 a heal? flexible sp5d+ acc\nt  
at ! end ( a plan ye> t an individual   
elects to contribute to a heal? sav+s   
acc\nt pursuant to a qualifi$ ,,hsa     
di/ribution 7z def9$ 9 section          
#ajf7;e77#b774  4  7d7 ,simplification (
 limitations on ,,fsa & ,,hra rollov]s  
,p>agraph 7#b7 ( section #ajf7;e7 ( su* 
,code is am5d$ to read z foll[s3  7#b7  
,qualifi$ ,,hsa di/ribution  7,a7 ,9    

g5]al ,! t]m qualifi$ ,,hsa di/ribution 
means a di/ribution f a heal? flexible  
sp5d+ arrangem5t or heal? reimbursem5t  
arrangem5t directly to a heal? sav+s    
acc\nt ( ! employee to ! ext5t t su*    
di/ribution does n exce$ ! less] (--    
7i7 ! balance 9 su* arrangem5t z ( !    
date ( su* di/ribution1 or  7ii7 ! am\nt
 det]m9$ "u subp>agraph 7,b74  ,su* t]m 
%all n include m ?an #a di/ribution )   
respect to any arrangem5t4  7,b7 ,doll> 
limitations  7i7 ,di/ributions f a heal?
 flexible sp5d+ arrangem5t ,a qualifi$  
,,hsa di/ribution f a heal? flexible    
sp5d+ arrangem5t %all n exce$ !         
applicable am\nt4  7ii7 ,di/ributions f 
a heal? reimbursem5t arrangem5t ,a      
qualifi$ ,,hsa di/ribution f a heal?    
reimbursem5t arrangem5t %all n exce$--  
7,i7 ! applicable am\nt divid$ by #ab1  
multipli$ by  7,,ii7 ! numb] ( mon?s    
dur+ :i* ! individual is a p>ticipant 9 
! heal? reimbursem5t arrangem5t4  7iii7 
,applicable am\nt ,= purposes ( ?is     
subp>agraph1 ! applicable am\nt is--    

7,i7 #b1bej 9 ! case ( an eligible      
individual :o has self-only cov]age "u  
an ,,hsa-qualifi$ heal? plan at ! "t (  
su* di/ribution1 &  7,,ii7 #d1ejj 9 !   
case ( an eligible individual :o has    
family cov]age "u an ,,hsa-qualifi$     
heal? plan at ! "t ( su* di/ribution4  4
  7e7 ,elim9ation ( additional tax =    
failure to ma9ta9 ,,hsa-,qualifi$ heal? 
plan cov]age ,subsection 7e7 ( section  
#ajf ( su* ,code is am5d$-- 7#a7 by     
/rik+ subp>agraph 7,a7 ( p>agraph 7#d7 &
 r$esignat+ subp>agraphs 7,b7 & 7,c7 (  
su* p>agraph z subp>agraphs 7,a7 & 7,b7 
!re(1 respectively2 &  7#b7 by /rik+    
p>agraph 7#c7 & r$esignat+ p>agraphs    
7#d7 7z s am5d$7 & 7#e7 z p>agraphs 7#c7
 & 7#d71 respectively4  7f7 ,limit$     
purpose ,f,s,as & ,h,r,as ,subsection   
7e7 ( section #ajf ( su* ,code1 z am5d$ 
by ?is section1 is am5d$ by add+ at !   
end ! foll[+ new p>agraph3  7#e7 ,limit$
 purpose ,f,s,as & ,h,r,as ,a plan %all 
n fail to be a heal? flexible sp5d+     
arrangem5t1 a heal? reimbursem5t        

arrangem5t1 or an accid5t or heal? plan 
"u ?is section or section #aje m]ely    
because ! plan conv]ts cov]age =        
individuals :o enroll 9 an              
,,hsa-qualifi$ heal? plan describ$ 9    
section #bbc7;c77#b7 to cov]age describ$
 9 subclause 7,i71 7,,ii71 7,,iii71     
7,,iv71 7,v71 or 7,,vi7 ( section       
#bbc7;c77#a77;,b77iv74 ,cov]age = su*   
individuals may be conv]t$ z ( ! date ( 
enrollm5t 9 ! ,,hsa-qualifi$ heal? plan1
 )\t reg>d to ! p]iod ( cov]age "u !    
heal? flexible sp5d+ arrangem5t or heal?
 reimbursem5t arrangem5t1 & )\t requir+ 
any *ange 9 cov]age to individuals :o d 
n enroll 9 an ,,hsa-qualifi$ heal? plan4
  4  7g7 ,di/ribution am\nts adju/$ =   
co/-(-,liv+ ,subsection 7e7 ( section   
#ajf ( su* ,code1 z am5d$ by ?is        
section1 is am5d$ by add+ at ! end !    
foll[+ new p>agraph3  7#f7 ,co/-(-liv+  
adju/m5t  7,a7 ,9 g5]al ,9 ! case ( any 
taxable ye> beg9n+ 9 a cal5d> ye> aft]  
#bjah1 ea* ( ! doll> am\nts 9 p>agraph  
7#b77;,b77iii7 %all be increas$ by an   

am\nt equal to su* doll> am\nt1         
multipli$ by ! co/-(-liv+ adju/m5t      
det]m9$ "u section #a7;f77#c7 = ! cal5d>
 ye> 9 :i* su* taxable ye> beg9s by     
sub/itut+ cal5d> ye> #bjag = cal5d> ye> 
#aiib 9 subp>agraph 7,b7 !re(4  7,b7    
,r\nd+ ,if any increase "u p>agraph 7#a7
 is n a multiple ( #ej1 su* increase    
%all be r\nd$ to ! ne>e/ multiple ( #ej4
  4  7h7 ,disclaim] ( disqualify+       
cov]age ,subp>agraph 7,b7 ( section     
#bbc7;c77#a7 ( su* ,code1 z am5d$ by ?is
 section1 is am5d$ by /rik+ & at ! end (
 clause 7iv71 by /rik+ ! p]iod at ! end 
( clause 7v7 & ins]t+ 1 &1 & by ins]t+  
aft] clause 7v7 ! foll[+ new clause3    
7iv7 any cov]age 7includ+ prospective   
cov]age7 "u a heal? plan t is n an      
,,hsa-qualifi$ heal? plan :i* is        
disclaim$ 9 writ+1 at ! "t ( ! creation 
or organization ( ! heal? sav+s acc\nt1 
includ+ by execution ( a tru/ describ$ 9
 subsection 7d77#a7 ?r\gh a gov]n+      
in/rum5t t includes su* a disclaim]1 or 
by acceptance ( an am5dm5t to su* a tru/

 t includes su* a disclaim]4  4  7i7    
,effective date ,! am5dm5ts made by ?is 
section %all apply to taxable ye>s      
beg9n+ aft] ! date ( ! enactm5t ( ?is   
,act4  #g4 ,*ronic disease prev5tion    
7a7 ,9 g5]al ,section #bbc7;c77#b7 ( !  
,int]nal ,rev5ue ,code ( #aihf is am5d$ 
by r$esignat+ subp>agraph 7,d7 z        
subp>agraph 7,e7 & by ins]t+ aft]       
subp>agraph 7,c7 ! foll[+ new           
subp>agraph3  7,d7 ,safe h>bor = abs5ce 
( d$uctible = c>e relat$ to *ronic      
conditions ,a plan %all n fail to be    
treat$ z a high d$uctible heal? plan by 
reason ( fail+ to h a d$uctible = c>e & 
prescription m$ications relat$ to !     
treatm5t ( m$ically complex *ronic      
conditions :i*--  7i7 are sub/antially  
disabl+ or life ?reat5+1  7ii7 h a high 
risk ( hospitalization or o!r           
significant adv]se heal? outcomes1 &    
7iii7 require specializ$ deliv]y sy/ems 
across doma9s ( c>e4  4  7b7 ,effective 
date ,! am5dm5ts made by ?is section    
%all apply to cov]age = mon?s beg9n+    

aft] ! date ( ! enactm5t ( ?is ,act4    
#h4 ,c]ta9 am\nts paid = physical       
activity1 fitness1 & ex]cise treat$ z   
am\nts paid = m$ical c>e  7a7 ,9 g5]al  
,section #bac7;d77#a7 ( ! ,int]nal      
,rev5ue ,code ( #aihf is am5d$ by /rik+ 
or at ! end ( subp>agraph 7,c71 by /rik+
 ! p]iod at ! end ( subp>agraph 7,d7 &  
ins]t+ 1 or1 & by ins]t+ aft]           
subp>agraph 7,d7 ! foll[+ new           
subp>agraph3  7,e7 = qualifi$ sports &  
fitness exp5ses4  4  7b7 ,qualifi$      
sports & fitness exp5ses ,section       
#bac7;d7 ( su* ,code1 z am5d$ by ?is    
,act1 is am5d$ by add+ at ! end ! foll[+
 p>agraph3  7#ac7 ,qualifi$ sports &    
fitness exp5ses  7,a7 ,9 g5]al ,! t]m   
qualifi$ sports & fitness exp5ses means 
am\nts paid exclusively = ! sole purpose
 ( p>ticipat+ 9 a physical activity     
includ+--  7i7 = memb]%ip at a fitness  
facility1  7ii7 = p>ticipation or       
in/ruction 9 a program ( physical       
ex]cise or physical activity1 &  7iii7 =
 equipm5t = use 9 a program 7includ+ a  

self-direct$ program7 ( physical ex]cise
 or physical activity4  7,b7 ,ov]all    
doll> limitation ,! aggregate am\nt     
treat$ z qualifi$ sports & fitness      
exp5ses ) respect to any taxpay] = any  
taxable ye> %all n exce$ #a1jjj 7#b1jjj 
9 ! case ( a jo9t return or a head (    
h\sehold 7z def9$ 9 section #b7;b7774   
7,c7 ,fitness facility def9$ ,= purposes
 ( subp>agraph 7,a77i71 ! t]m fitness   
facility means a facility-- 7i7 provid+ 
in/ruction 9 a program ( physical       
ex]cise1 (f]+ facilities = !            
pres]vation1 ma9t5ance1 enc\ragem5t1 or 
developm5t ( physical fitness1 or s]v+ z
 ! site ( su* a program ( a ,/ate or    
local gov]nm5t1  7ii7 :i* is n a private
 club own$ & op]at$ by its memb]s1      
7iii7 :i* does n (f] golf1 hunt+1 sail+1
 or rid+ facilities1  7iv7 ^: heal? or  
fitness facility is n incid5tal to its  
ov]all function & purpose1 &  7v7 :i* is
 fully compliant ) ! ,/ate (            
jurisdiction & ,f$]al anti-discrim9ation
 laws4  7,d7 ,treatm5t ( ex]cise videos1

 etc ,videos1 books1 & simil> mat]ials  
%all be treat$ z describ$ 9 subp>agraph 
7,a77ii7 if ! cont5t ( su* mat]ials     
con/itute in/ruction 9 a program (      
physical ex]cise or physical activity4  
7,e7 ,limitations relat$ to sports &    
fitness equipm5t ,am\nts paid = equipm5t
 describ$ 9 subp>agraph 7,a77iii7 %all  
be treat$ z a qualifi$ sports & fitness 
exp5se only--  7i7 if su* equipm5t is   
utiliz$ exclusively = p>ticipation 9    
fitness1 ex]cise1 sport1 or o!r physical
 activity programs1  7ii7 if su*        
equipm5t is n app>el or footwe>1 &      
7iii7 9 ! case ( any item ( sports      
equipm5t 7o!r ?an ex]cise equipm5t71 )  
respect to s mu* ( ! am\nt paid = su*   
item z does n exce$ #bej4  7,f7         
,programs :i* include compon5ts o!r ?an 
physical ex]cise & physical activity    
,rules simil> to ! rules ( section      
#bac7;d77#f7 %all apply 9 ! case ( any  
program t includes physical ex]cise or  
physical activity & also o!r compon5ts4 
,= purposes ( ! prec$+ s5t5ce1 travel & 

accommodations %all be treat$ z an o!r  
compon5t4  4  7c7 ,effective date ,!    
am5dm5ts made by ?is section %all apply 
to taxable ye>s beg9n+ aft] ! date ( !  
enactm5t ( ?is ,act4