,i  #aai? ,,congress  #a/ ,session  ,h4 
,r4 #fahc  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,novemb] #bj1         
#bjbe,mr4 ,doggett introduc$ ! foll[+   
bill2 :i* 0 ref]r$ to ! ,committee on   
,ways & ,means  ,a ,,bill  ,to am5d !   
,int]nal ,rev5ue ,code ( #aihf to re=m  
c]ta9 rules relat$ to heal? sav+s       
acc\nts4  #a4 ,ref]5ces ,except z       
o!rwise expressly provid$1 :5ev] 9 ?is  
,act an am5dm5t or repeal is express$ 9 
t]ms ( an am5dm5t to1 or repeal (1 a    
section or o!r provision1 ! ref]5ce %all
 be consid]$ to be made to a section or 
o!r provision ( ! ,int]nal ,rev5ue ,code
 ( #aihf4  #b4 ,repeal ( exception to   
requirem5t t p5alty-free di/ributions be
 = qualifi$ m$ical exp5ses  7a7 ,9 g5]al
 ,section #bbc7;f77#d7 is am5d$ by /rik+
 subp>agraph 7,c74  7b7 ,effective date 
,! am5dm5t made by ?is section %all     
apply to di/ributions made aft] ,decemb]
 #ca1 #bjbe4  #c4 ,income limitation on 
d$uctible contributions to heal? sav+s  
acc\nts  7a7 ,9 g5]al ,section #bbc7;b7 

is am5d$ by add+ at ! end ! foll[+ new  
p>agraph3  7#i7 ,limitation bas$ on     
modifi$ adju/$ gross income  7,a7 ,9    
g5]al ,! am\nt o!rwise all[able z a     
d$uction "u subsection 7a7 %all be r$uc$
 7b n bel[ z]o7 by an am\nt :i* be>s !  
same ratio to ! am\nt s all[able        
7det]m9$ )\t reg>d to ?is p>agraph7 z-- 
7i7 ! am\nt 7if any7 by :i* ! taxpay]'s 
modifi$ adju/$ gross income exce$s !    
applicable income ?re%old1 be>s to  7ii7
 #dj1jjj 7#bj1jjj 9 ! case ( a m>ri$    
individual fil+ a sep>ate return74  7,b7
 ,applicable income ?re%old ,= purposes 
( ?is p>agraph1 ! t]m applicable income 
?re%old means--  7i7 9 ! case ( a jo9t  
return or surviv+ sp\se 7z def9$ 9      
section #b7;a771 #cjj1jjj1  7ii7 9 !    
case ( a head ( h\sehold1 #bej1jjj1     
7iii7 9 ! case ( a m>ri$ individual fil+
 a sep>ate return1 #aej1jjj1 &  7iv7 9  
any o!r case1 #bjj1jjj4  7,c7 ,modifi$  
adju/$ gross income ,= purposes ( ?is   
p>agraph1 ! t]m modifi$ adju/$ gross    
income means adju/$ gross income det]m9$

 )\t reg>d to ?is section & sections    
#iaa1 #ica1 & #icc4  4  7b7 ,treatm5t ( 
non-d$uctible contributions  7#a7 ,rules
 = di/ribution ,section #bbc7;f77#b7 is 
am5d$ is am5d$ by /rik+ %all be includ$ 
9 ! gross income ( su* b5efici>y4 &     
ins]t+ %all be includ$ 9 ! gross income 
( ! b5efici>y z provid$ 9 section #gb4  
,rules simil> to ! rules ( section      
#djh7;d77#b7 %all apply = purposes ( !  
prec$+ s5t5ce44  7#b7 ,coord9ation )    
excise tax on excess contributions      
,section #digc7;g77#a7 is am5d$ by      
ins]t+ 7det]m9$ )\t reg>d to section    
#bbc7;b77#i77 aft] section #bbc4  7c7   
,payroll taxes  7#a7 ,,fica ,section    
#caba7;a7 is am5d$ by /rik+ or at ! end 
( p>agraph 7#bb71 by /rik+ ! p]iod at ! 
end ( p>agraph 7#bc7 & ins]t+ 2 or1 & by
 ins]t+ af] p>agraph 7#bc7 ! foll[+ new 
p>agraph3  7#bd7  7,a7 = purposes (     
section #caja1 any paym5t excludable f !
 employee's gross income "u section     
#ajf7;d71 &  7,b7 = purposes ( any o!r  
provision ( ?is *apt] 7includ+ section  

#cajb71 any paym5t made to or = ! b5efit
 ( an employee if at ! "t ( su* paym5t x
 is reasonable to believe t ! employee w
 be able to exclude su* paym5t f income 
"u section #ajf7;d74  4  7#b7 ,railroad 
,retirem5t ,section #cbca7;e77#aa7 is   
am5d$ to read z foll[s3  7#aa7 7,a7 =   
purposes ( section #cbja1 any paym5t    
excludable f ! employee's gross income  
"u section #ajf7;d71 &  7,b7 = purposes 
( any o!r provision ( ?is *apt] 7includ+
 section #cbjb71 any paym5t made to or =
 ! b5efit ( an employee if at ! "t ( su*
 paym5t x is reasonable to believe t !  
employee w be able to exclude su* paym5t
 f income "u section #ajf7;d72  4  7d7  
,effective date  7#a7 ,9 g5]al ,except z
 o!rwise provid$ 9 ?is subsection1 !    
am5dm5ts made by ?is section %all apply 
to taxable ye>s beg9n+ aft] ,decemb]    
#ca1 #bjbe4  7#b7 ,payroll taxes ,!     
am5dm5ts made by subsection 7c7 %all    
apply to paym5ts made aft] ,decemb] #ca1
 #bjbe4  #d4 ,heal? sav+s acc\nt        
reimbursem5t ( m$ical exp5ses limit$ to 

#b ye>s  7a7 ,9 g5]al ,section          
#bbc7;d77#b7 is am5d$ by add+ at ! end !
 foll[+ new subp>agraph3  7,e7          
,reimbursem5ts limit$ to #b ye>s ,an    
am\nt paid or di/ribut$ f a heal? sav+s 
acc\nt to reimburse ! acc\nt b5efici>y =
 a qualifi$ m$ical exp5se %all n be     
treat$ z us$ to pay a qualifi$ m$ical   
exp5se unless su* di/ribution is made n 
lat] ?an #b ye>s aft] ! date on :i* su* 
reimburs$ qualifi$ m$ical exp5se 0 paid4
  4  7b7 ,effective date ,! am5dm5t made
 by ?is section %all apply to am\nts    
paid or di/ribut$ f a heal? sav+s acc\nt
 aft] ,decemb] #ca1 #bjbe4  #e4         
,requirem5t to sub/antiate di/ributions 
f heal? sav+s acc\nts t are = qualifi$  
m$ical exp5ses  7a7 ,9 g5]al ,section   
#bbc7;d77#b71 z am5d$ by ! prec$+       
provisions ( ?is ,act1 is am5d$ by add+ 
at ! end ! foll[+ new subp>agraph3  7,f7
 ,sub/antiation requirem5t  7i7 ,9 g5]al
 ,an am\nt paid or di/ribut$ f a heal?  
sav+s acc\nt %all n be treat$ z us$ to  
pay a qualifi$ m$ical exp5se unless su* 

am\nt is sub/antiat$ z a qualifi$ m$ical
 exp5se4  7ii7 ,assessm5t requir$ ,9 !  
case ( any exp5se ) respect to :i* a    
provid]'s op9ion is requir$ to          
sub/antiate su* exp5se z a qualifi$     
m$ical exp5se "u clause 7i71 su* op9ion 
%all n con/itute sub/antiation unless-- 
7,i7 su* op9ion is bas$ on an assessm5t 
conduct$ pursuant to a bona fide        
provid]-pati5t relation%ip1  7,,ii7 su* 
assessm5t is conduct$ 9-p]son or is an  
assessm5t ( a type t g5]ally accept$    
/&>ds ( m$ical practice d n require to  
be 9-p]son1 &  7,,iii7 ! exp5se is      
incurr$ = an item or s]vice ( a type t  
w\ld be typically recomm5d$ "u g5]ally  
accept$ /&>ds ( m$ical practice4  7,g7  
,regulations ,! ,secret>y %all issue su*
 regulations or o!r guidance z may be   
necess>y or appropriate to c>ry out !   
purposes ( ?is subp>agraph4  4  7b7     
,det]m9ation by tru/ee ,section         
#bbc7;d77#a7 is am5d$ by add+ at ! end !
 foll[+ new subp>agraph3  7,f7 ,9 ! case
 ( any am\nt paid or di/ribut$ f ! tru/1

 ! tru/ee %all det]m9e1 consi/5t ) !    
requirem5ts ( p>agraph 7#b77;,f71 :e!r  
su* am\nt has be5 sub/antiat$ z a       
qualifi$ m$ical exp5se4  4  7c7         
,effective date ,! am5dm5ts made by ?is 
section %all apply to am\nts paid or    
di/ribut$ f a heal? sav+s acc\nt aft]   
,decemb] #ca1 #bjbe4  #f4 ,c]ta9 exp5ses
 n treat$ z m$ical c>e  7a7 ,9 g5]al    
,section #bbc7;d77#b71 z am5d$ by !     
prec$+ provisions ( ?is ,act1 is am5d$  
by add+ at ! end ! foll[+ new           
subp>agraph3  7,g7 ,exclusions ,=       
purposes ( ?is p>agraph1 ! am\nts paid =
 ! foll[+ %all n be treat$ z paid =     
m$ical c>e3  7i7 ,spa & beauty          
treatm5ts4  7ii7 ,s mu* ( any am\nts    
paid = ex]cise equipm5t z exce$ #ejj 9  
any taxable ye>4  4  7b7 ,effective date
 ,! am5dm5t made by ?is section %all    
apply to am\nts paid or di/ribut$ f a   
heal? sav+s acc\nt aft] ,decemb] #ca1   
#bjbe4  #g4 ,excise tax on excessive    
heal? sav+s acc\nt fees  7a7 ,9 g5]al   
,subtitle ,d is am5d$ by add+ at ! end !

 foll[+ new *apt]3  #ej;,b ,excessive   
heal? sav+s acc\nt fees  ,sec4 #ejjj;,e4
 ,excessive heal? sav+s acc\nt fees4    
#ejjj;,e4 ,excessive heal? sav+s acc\nt 
fees  7a7 ,9 g5]al ,!re is h]eby impos$ 
on ! tru/ee ( any heal? sav+s acc\nt :i*
 *>ges any excessive heal? sav+s acc\nt 
fee a tax equal to ! excess (-- 7#a7 !  
am\nt ( su* fee1 ov]  7#b7 ! reasonable 
am\nt ( su* fee z det]m9$ "u subsection 
7b77#c74  7b7 ,excessive heal? sav+     
acc\nt fee ,= purposes ( ?is section--  
7#a7 ,excessive heal? sav+s acc\nt fee  
,! t]m excessive heal? sav+s acc\nt fee 
means any cov]$ heal? sav+s acc\nt fee  
if su* fee exce$s ! reasonable am\nt (  
su* fee z det]m9$ "u p>agraph 7#c74     
7#b7 ,cov]$ heal? sav+s acc\nt fee ,!   
t]m cov]$ heal? sav+s acc\nt fee means  
any ( ! foll[+ if *>g$ 9 connection ) a 
heal? sav+s acc\nt3 ma9t5ance fees2     
transf] fees2 fees = pap] /atem5ts1     
*ecks1 or replacem5t c>ds2 )drawal fees2
 fees = insuffici5t funds2 fees to      
ensure t fees d n exce$ e>n+s or acc\nt 

balance2 & su* o!r fees or *>ges z !    
,secret>y may id5tify = purposes ( ?is  
p>agraph4  7#c7 ,reasonable fees ,)     
respect to ea* category ( fees describ$ 
9 p>agraph 7#b7 & su* additional        
categories or subcategories z !         
,secret>y may provide1 ! ,secret>y %all 
det]m9e ! reasonable am\nt ( su* fee4   
7c7 ,heal? sav+ acc\nt ,= purposes ( ?is
 section1 ! t]m heal? sav+s acc\nt has !
 mean+ giv5 su* t]m 9 section #bbc4  4  
7b7 ,report+ ,subp>t ,a ( "p ,,iii (    
sub*apt] ,a ( *apt] #fa is am5d$ by     
ins]t+ aft] section #fjci,l ! foll[+ new
 section3  #fjci,m4 ,in=mation reg>d+   
heal? sav+s acc\nt fees  7a7 ,9 g5]al   
,ea* tru/ee ( a heal? sav+s acc\nt :i*  
*>ges any cov]$ heal? sav+s acc\nt fee  
dur+ any cal5d> ye> %all1 = su* cal5d>  
ye>1 make a return at su* "t & 9 su*    
mann] z ! ,secret>y may provide sett+ =?
 ! in=mation describ$ 9 subsection 7b7 &
 su* o!r in=mation z ! ,secret>y may    
require4  7b7 ,in=mation  7#a7 ,9 g5]al 
,ea* return "u subsection 7a7 %all      

include1 ) respect to ea* category ( fee
 *>g$1 a description ( su* fee1 ! numb] 
( su* fees *>g$1 & ! aggregate am\nt (  
su* fees *>g$4  7#b7 ,sep>ately /at$    
categories ,! in=mation describ$ 9      
p>agraph 7#a7 %all be sep>ately /at$    
bas$ on su* demographic or o!r          
*>act]i/ics z ! ,secret>y may provide4  
7c7 ,def9itions ,t]ms us$ 9 ?is section 
:i* are also us$ 9 section #ejjj;,e %all
 h ! same mean+ z :5 us$ 9 section      
#ejjj;,e4  4  7c7 ,cl]ical am5dm5ts     
7#a7 ,! table ( *apt]s = subtitle ,d is 
am5d$ by add+ at ! end ! foll[+ new     
item3  ,*apt] #ej;,b--,excessive heal?  
sav+s acc\nt fees  4  7#b7 ,! table (   
sections = subp>t ,a ( "p ,,iii (       
sub*apt] ,a ( *apt] #fa is am5d$ by     
ins]t+ aft] ! item relat+ to section    
#fjci,l ! foll[+ new item3  ,sec4       
#fjci,m4 ,in=mation reg>d+ heal? sav+s  
acc\nt fees4  4  7d7 ,effective date ,! 
am5dm5ts made by ?is section %all apply 
to fees *>g$ aft] ,decemb] #ca1 #bjbe4  
#h4 ,report+ ( e>n+s on ca% balances (  

heal? sav+s acc\nts  7a7 ,9 g5]al       
,section #bbc7;h7 is am5d$ by add+ at ! 
end ! foll[+3 ,! reports "u p>agraph    
7#a7 %all include a /atem5t specify+ !  
av]age yield on ca% balances 9 ! heal?  
sav+s acc\nt ( ! acc\nt b5efici>y = !   
p]iod cov]$ by ! report & a /atem5t ( ! 
national av]age yield on sav+s acc\nt   
balances = su* p]iod 7det]m9$ 9 su*     
mann] z ! ,secret>y may provide744  7b7 
,effective date ,! am5dm5t made by ?is  
section %all apply to reports ) respect 
to p]iods beg9n+ aft] ,decemb] #ca1     
#bjbe4