,i #aahth ,,congress #ast ,session ,h4 ,r4 #efjh ,,in ,,the ,,house ,,of ,,representatives ,september #bj1 #bjbc,mr4 ,steube 7for himself and ,mrs4 ,cammack7 introduced the following bill2 which was referred to the ,committee on ,ways and ,means1 and in addition to the ,committee on ,energy and ,commerce1 for a period to be subsequently determined by the ,speaker1 in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned ,a ,,bill ,to allow individuals to elect to receive contributions to a health savings account in lieu of reduced cost-sharing under health insurance obtained through a health insurance ,exchange4 #a4 ,short title ,this ,act may be cited as the ,affordable ,care and ,comprehensive ,economic ,support through ,savings ,act or the ,,access ,act4 #b4 ,health savings account contributions in lieu of reduced cost-sharing 7a7 ,in general ,section #bbc of the ,internal ,revenue ,code of #aihf is amended by adding at the end the following new subsection3 7i7 ,health savings account contributions in lieu of reduced cost-,sharing for ,exchange-,provided plans 7#a7 ,in general ,in the case of any eligible insured who is enrolled in an ,exchange-provided high deductible health plan for any month and who elects 7at such time and in such manner as the ,secretary may provide7 the application of this subsection-- 7,a7 section #adjb of the ,patient ,protection and ,affordable ,care ,act shall not apply to such individual for such month1 7,b7 the health insurance issuer offering such plan shall make a payment to a health savings account of such individual for such month in an amount equal to #a_/ab of the annual reduced cost-sharing actuarial equivalent amount1 and 7,c7 the ,secretary shall make payments to such health insurance issuer in amounts which are equal to the payments made by such issuer under subparagraph 7,b74 7#b7 ,annual reduced cost-sharing actuarial equivalent amount ,for purposes of this section1 the term annual reduced cost-sharing actuarial equivalent amount means1 with respect to any ,exchange-provided high deductible health plan enrolled in by an eligible insured1 an amount that would produce an actuarial value equal to the actuarial value of the reduction in cost-sharing 7as determined under section #adjb of the ,patient ,protection and ,affordable ,care ,act and without regard to any election under this subsection7 for the plan year determined by taking into account the household income of the eligible insured4 7#c7 ,restriction on distributions 7,a7 ,in general ,any trust which receives a payment described in paragraph 7#a77;,b7 shall not be treated as a health savings account for purposes of this section unless the terms of such trust require that1 during any month during which such a payment is received1 no distribution may be made from such trust unless such distribution is made to satisfy a charge properly made to a qualified medical debit card4 7,b7 ,qualified medical debit card ,for purposes of this paragraph1 the term qualified medical debit card means a debit card which-- 7i7 is issued by a bank 7as defined in section #djh7n771 7ii7 is provided by the trustee of the health savings account to the designated beneficiary1 and 7iii7 is encoded in such a manner that the only expenses which may charged with such card are amounts paid for medical care 7as defined in section #bac7;d774 7#d7 ,recapture of excess payments ,for purposes of applying the recapture rules of section #cf;,b7f77#b7-- 7,a7 payments made to the health savings account of an individual under paragraph 7#a77;,b7 shall be treated as an advance payment of the credit allowed under section #cf;,b1 and 7,b7 the credit allowed under section #cf;,b shall be treated as having been increased by the payments which would have been made to the health savings account of such individual under paragraph 7#a77;,b7 if such payments had been determined using the household income of such individual for the taxable year referred to in such section4 7#e7 ,other definitions and special rules ,for purposes of this section-- 7,a7 ,exchange-provided high deductible health plan ,the term ,exchange-provided high deductible health plan means1 with respect to any eligible insured1 any high deductible health plan enrolled in by such eligible insured through an ,exchange established under the ,patient ,protection and ,affordable ,care ,act4 7,b7 ,eligible insured ,the term eligible insured has the meaning given such term in section #adjb7;b7 of the ,patient ,protection and ,affordable ,care ,act4 7,c7 ,coordination with contribution limits2 etc ,the payments described in paragraph 7#a77;,b7 shall not fail to be taken into account under this section as contributions to the health savings account to which paid and such payments shall not be required to be made to the extent that the eligible insured does not have a health savings account or such account is prohibited from accepting such payment by reason of subsection 7d77#a77;,a77ii74 4 7b7 ,requirements related to ,exchange-,provided high deductible health plans ,section #acja7;a7 of the ,patient ,protection and ,affordable ,care ,act 7#db ,u4,s4,c4 #ahjba7;a77 is amended by adding at the end the following new paragraph3 7#e7 ,requirements related to high deductible health plans 7,a7 ,requirement to offer high deductible health plan as alternative ,a health plan in the silver level of coverage in the individual market which is not a high deductible health plan shall not be treated as a qualified health plan unless the health insurance issuer offering such plan offers a high deductible health plan which is actuarially equivalent to such plan to any individual who would be an eligible insured 7as defined in section #adjb7;b77 if such individual were enrolled in such plan4 7,b7 ,requirement to make health savings account contributions upon election of eligible insured ,a high deductible health plan shall not be treated as a qualified health plan unless the health insurance issuer offering such plan complies with the requirement of section #bbc7;i77#a77;,b7 of such ,code with respect to such plan4 7,c7 ,determination of actuarial value ,for purposes of this ,act1 the actuarial value of a high deductible health plan shall take into account payments made by the issuer to a health savings account of the enrollee pursuant to such plan4 7,d7 ,high deductible health plan ,for purposes of this paragraph1 the term high deductible health plan has the meaning given such term by section #bbc of the ,internal ,revenue ,code of #aihf4 4 7c7 ,public education ,beginning on ,january #a1 #bjbe1 each health insurance issuer offering coverage through an ,exchange established under the ,patient ,protection and ,affordable ,care ,act1 and each such ,exchange1 shall provide all prospective enrollees-- 7#a7 information regarding the availability of insurer-provided health savings account contributions in lieu of reduced cost-sharing for silver level high deductible health plans selected in the ,exchange1 and 7#b7 information regarding how to establish and use a health savings account4 7d7 ,permanent appropriation for cost-,sharing reduction payments and ,,hsa contributions made in lieu of such payments ,necessary amounts are appropriated to the ,secretary of the ,treasury for making payments described in section #adjb7;d77#c7 of the ,patient ,protection and ,affordable ,care ,act1 and payments described in section #bbc7;i77#a77;,c7 of the ,internal ,revenue ,code of #aihf 7as added by this section71 for months beginning after ,december #ca1 #bjbd4 7e7 ,effective date ,the amendments made by this section shall apply to months beginning after ,december #ca1 #bjbd4