,i  #aah? ,,congress  #a/ ,session  ,h4 
,r4 #efjh  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,septemb] #bj1        
#bjbc,mr4 ,/eube 7= himself & ,mrs4     
,cammack7 introduc$ ! foll[+ bill2 :i* 0
 ref]r$ to ! ,committee on ,ways &      
,means1 & 9 addition to ! ,committee on 
,en]gy & ,comm]ce1 = a p]iod to be      
subsequ5tly det]m9$ by ! ,speak]1 9 ea* 
case = consid]ation ( su* provisions z  
fall )9 ! jurisdiction ( ! committee    
conc]n$  ,a ,,bill  ,to all[ individuals
 to elect to receive contributions to a 
heal? sav+s acc\nt 9 lieu ( r$uc$       
co/-%>+ "u heal? insurance obta9$ ?r\gh 
a heal? insurance ,ex*ange4  #a4 ,%ort  
title ,?is ,act may be cit$ z !         
,af=dable ,c>e & ,compreh5sive ,economic
 ,support ?r\gh ,sav+s ,act or !        
,,access ,act4  #b4 ,heal? sav+s acc\nt 
contributions 9 lieu ( r$uc$ co/-%>+    
7a7 ,9 g5]al ,section #bbc ( ! ,int]nal 
,rev5ue ,code ( #aihf is am5d$ by add+  
at ! end ! foll[+ new subsection3  7i7  
,heal? sav+s acc\nt contributions 9 lieu

 ( r$uc$ co/-,%>+ = ,ex*ange-,provid$   
plans  7#a7 ,9 g5]al ,9 ! case ( any    
eligible insur$ :o is enroll$ 9 an      
,ex*ange-provid$ high d$uctible heal?   
plan = any mon? & :o elects 7at su* "t &
 9 su* mann] z ! ,secret>y may provide7 
! application ( ?is subsection-- 7,a7   
section #adjb ( ! ,pati5t ,protection & 
,af=dable ,c>e ,act %all n apply to su* 
individual = su* mon?1  7,b7 ! heal?    
insurance issu] (f]+ su* plan %all make 
a paym5t to a heal? sav+s acc\nt ( su*  
individual = su* mon? 9 an am\nt equal  
to #a_/ab ( ! annual r$uc$ co/-%>+      
actu>ial equival5t am\nt1 &  7,c7 !     
,secret>y %all make paym5ts to su* heal?
 insurance issu] 9 am\nts :i* are equal 
to ! paym5ts made by su* issu] "u       
subp>agraph 7,b74  7#b7 ,annual r$uc$   
co/-%>+ actu>ial equival5t am\nt ,=     
purposes ( ?is section1 ! t]m annual    
r$uc$ co/-%>+ actu>ial equival5t am\nt  
means1 ) respect to any ,ex*ange-provid$
 high d$uctible heal? plan enroll$ 9 by 
an eligible insur$1 an am\nt t w\ld     

produce an actu>ial value equal to !    
actu>ial value ( ! r$uction 9 co/-%>+ 7z
 det]m9$ "u section #adjb ( ! ,pati5t   
,protection & ,af=dable ,c>e ,act & )\t 
reg>d to any election "u ?is subsection7
 = ! plan ye> det]m9$ by tak+ into      
acc\nt ! h\sehold income ( ! eligible   
insur$4  7#c7 ,re/riction on            
di/ributions  7,a7 ,9 g5]al ,any tru/   
:i* receives a paym5t describ$ 9        
p>agraph 7#a77;,b7 %all n be treat$ z a 
heal? sav+s acc\nt = purposes ( ?is     
section unless ! t]ms ( su* tru/ require
 t1 dur+ any mon? dur+ :i* su* a paym5t 
is receiv$1 no di/ribution may be made f
 su* tru/ unless su* di/ribution is made
 to satisfy a *>ge prop]ly made to a    
qualifi$ m$ical debit c>d4  7,b7        
,qualifi$ m$ical debit c>d ,= purposes (
 ?is p>agraph1 ! t]m qualifi$ m$ical    
debit c>d means a debit c>d :i*-- 7i7 is
 issu$ by a bank 7z def9$ 9 section     
#djh7n771  7ii7 is provid$ by ! tru/ee (
 ! heal? sav+s acc\nt to ! designat$    
b5efici>y1 &  7iii7 is encod$ 9 su* a   

mann] t ! only exp5ses :i* may *>g$ )   
su* c>d are am\nts paid = m$ical c>e 7z 
def9$ 9 section #bac7;d774  7#d7        
,recapture ( excess paym5ts ,= purposes 
( apply+ ! recapture rules ( section    
#cf;,b7f77#b7-- 7,a7 paym5ts made to !  
heal? sav+s acc\nt ( an individual "u   
p>agraph 7#a77;,b7 %all be treat$ z an  
advance paym5t ( ! cr$it all[$ "u       
section #cf;,b1 &  7,b7 ! cr$it all[$ "u
 section #cf;,b %all be treat$ z hav+   
be5 increas$ by ! paym5ts :i* w\ld h be5
 made to ! heal? sav+s acc\nt ( su*     
individual "u p>agraph 7#a77;,b7 if su* 
paym5ts _h be5 det]m9$ us+ ! h\sehold   
income ( su* individual = ! taxable ye> 
ref]r$ to 9 su* section4  7#e7 ,o!r     
def9itions & special rules ,= purposes (
 ?is section-- 7,a7 ,ex*ange-provid$    
high d$uctible heal? plan ,! t]m        
,ex*ange-provid$ high d$uctible heal?   
plan means1 ) respect to any eligible   
insur$1 any high d$uctible heal? plan   
enroll$ 9 by su* eligible insur$ ?r\gh  
an ,ex*ange e/abli%$ "u ! ,pati5t       

,protection & ,af=dable ,c>e ,act4  7,b7
 ,eligible insur$ ,! t]m eligible insur$
 has ! mean+ giv5 su* t]m 9 section     
#adjb7;b7 ( ! ,pati5t ,protection &     
,af=dable ,c>e ,act4  7,c7 ,coord9ation 
) contribution limits2 etc ,! paym5ts   
describ$ 9 p>agraph 7#a77;,b7 %all n    
fail to be tak5 into acc\nt "u ?is      
section z contributions to ! heal? sav+s
 acc\nt to :i* paid & su* paym5ts %all n
 be requir$ to be made to ! ext5t t !   
eligible insur$ does n h a heal? sav+s  
acc\nt or su* acc\nt is prohibit$ f     
accept+ su* paym5t by reason (          
subsection 7d77#a77;,a77ii74  4  7b7    
,requirem5ts relat$ to ,ex*ange-,provid$
 high d$uctible heal? plans ,section    
#acja7;a7 ( ! ,pati5t ,protection &     
,af=dable ,c>e ,act 7#db ,u4,s4,c4      
#ahjba7;a77 is am5d$ by add+ at ! end ! 
foll[+ new p>agraph3  7#e7 ,requirem5ts 
relat$ to high d$uctible heal? plans    
7,a7 ,requirem5t to (f] high d$uctible  
heal? plan z alt]native ,a heal? plan 9 
! silv] level ( cov]age 9 ! individual  

m>ket :i* is n a high d$uctible heal?   
plan %all n be treat$ z a qualifi$ heal?
 plan unless ! heal? insurance issu]    
(f]+ su* plan (f]s a high d$uctible     
heal? plan :i* is actu>ially equival5t  
to su* plan to any individual :o w\ld be
 an eligible insur$ 7z def9$ 9 section  
#adjb7;b77 if su* individual 7 enroll$ 9
 su* plan4  7,b7 ,requirem5t to make    
heal? sav+s acc\nt contributions ^u     
election ( eligible insur$ ,a high      
d$uctible heal? plan %all n be treat$ z 
a qualifi$ heal? plan unless ! heal?    
insurance issu] (f]+ su* plan complies )
 ! requirem5t ( section                 
#bbc7;i77#a77;,b7 ( su* ,code ) respect 
to su* plan4  7,c7 ,det]m9ation (       
actu>ial value ,= purposes ( ?is ,act1 !
 actu>ial value ( a high d$uctible heal?
 plan %all take into acc\nt paym5ts made
 by ! issu] to a heal? sav+s acc\nt ( ! 
enrollee pursuant to su* plan4  7,d7    
,high d$uctible heal? plan ,= purposes (
 ?is p>agraph1 ! t]m high d$uctible     
heal? plan has ! mean+ giv5 su* t]m by  

section #bbc ( ! ,int]nal ,rev5ue ,code 
( #aihf4  4  7c7 ,public education      
,beg9n+ on ,janu>y #a1 #bjbe1 ea* heal? 
insurance issu] (f]+ cov]age ?r\gh an   
,ex*ange e/abli%$ "u ! ,pati5t          
,protection & ,af=dable ,c>e ,act1 & ea*
 su* ,ex*ange1 %all provide all         
prospective enrollees-- 7#a7 in=mation  
reg>d+ ! availability ( insur]-provid$  
heal? sav+s acc\nt contributions 9 lieu 
( r$uc$ co/-%>+ = silv] level high      
d$uctible heal? plans select$ 9 !       
,ex*ange1 &  7#b7 in=mation reg>d+ h[ to
 e/abli% & use a heal? sav+s acc\nt4    
7d7 ,p]man5t appropriation = co/-,%>+   
r$uction paym5ts & ,,hsa contributions  
made 9 lieu ( su* paym5ts ,necess>y     
am\nts are appropriat$ to ! ,secret>y ( 
! ,treasury = mak+ paym5ts describ$ 9   
section #adjb7;d77#c7 ( ! ,pati5t       
,protection & ,af=dable ,c>e ,act1 &    
paym5ts describ$ 9 section              
#bbc7;i77#a77;,c7 ( ! ,int]nal ,rev5ue  
,code ( #aihf 7z add$ by ?is section71 =
 mon?s beg9n+ aft] ,decemb] #ca1 #bjbd4 

7e7 ,effective date ,! am5dm5ts made by 
?is section %all apply to mon?s beg9n+  
aft] ,decemb] #ca1 #bjbd4