,,ii #aaith ,,congress #ast ,session ,s4 #ccfb ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,december #d1 #bjbe,mr4 ,paul introduced the following bill2 which was read twice and referred to the ,committee on ,finance ,a ,,bill ,to amend the ,internal ,revenue ,code of #aihf to increase the limitations on contributions to health savings accounts1 and for other purposes4 #a4 ,short title2 table of contents 7a7 ,short title ,this ,act may be cited as the ,health ,marketplace and ,savings ,accounts for ,all ,act4 7b7 ,table of contents ,the table of contents for this ,act is as follows3 ,sec4 #a4 ,short title2 table of contents4,,title ,i--,health ,savings ,accounts,sec4 #aja4 ,short title4,sec4 #ajb4 ,increase in contribution limitations4,sec4 #ajc4 ,freedom from mandate4,sec4 #ajd4 ,amounts paid for health insurance or direct primary care service arrangement4,sec4 #aje4 ,special rule for certain medical expenses incurred before establishment of account4,sec4 #ajf4 ,administrative error correction before due date of return4,sec4 #ajg4 ,allowing ,,hsa rollover to child or parent of account holder4,sec4 #ajh4 ,coverage for amounts paid for vitamins1 dietary supplements1 gym memberships1 and wearable fitness trackers4,sec4 #aji4 ,equivalent bankruptcy protections for health savings accounts as retirement funds4,,title ,,ii--,health ,marketplace for ,all,sec4 #bja4 ,short title4,sec4 #bjb4 ,health marketplace pools deemed an employer for purposes of offering group health plans or group health insurance coverage4,sec4 #bjc4 ,conforming amendments4 ,i ,health ,savings ,accounts #aja4 ,short title ,this title may be cited as the ,health ,savings ,accounts ,for ,all ,act of #bjbe4 #ajb4 ,increase in contribution limitations 7a7 ,in general ,subsection 7b7 of section #bbc of the ,internal ,revenue ,code of #aihf is amended-- 7#a7 in paragraph 7#a71 by striking the sum of and all that follows through the period and inserting an amount equal to the applicable dollar amount under paragraph 7#a77;,b7 of section #djb7;g7 7as adjusted pursuant to paragraph 7#d7 of such section7 with respect to such taxable year41 7#b7 by striking paragraphs 7#b71 7#c71 7#e71 7#g71 and 7#h71 7#c7 by inserting after paragraph 7#a7 the following3 7#b7 ,additional contributions for individuals #ej or older ,in the case of an individual who has attained age #ej before the close of the taxable year1 the amount of the limitation under paragraph 7#a7 shall be increased by an amount equal to the applicable dollar amount under subparagraph 7,b77i7 of section #dad7v77#b7 7as adjusted pursuant to subparagraph 7,c7 of such section74 1 7#d7 in paragraph 7#d71 by striking the flush matter following subparagraph 7,c71 and 7#e7 by redesignating paragraphs 7#d7 and 7#f7 as paragraphs 7#c7 and 7#d71 respectively4 7b7 ,conforming amendments 7#a7 ,subparagraph 7,a7 of section #bbc7;d77#a7 of the ,internal ,revenue ,code of #aihf is amended by striking the sum of-- and all that follows through the period and inserting the amount determined under subsection 7b77#a744 7#b7 ,subsection 7g77#a7 of section #bbc of such ,code is amended-- 7,a7 by striking 7b77#b71 7c77#b77;,a71 and and inserting 7c77#b77;,a7 and11 7,b7 by amending subparagraph 7,b7 to read as follows3 7,b7 the cost-of-living adjustment determined under section #a7;f77#c7 for the calendar year in which such taxable year begins determined by substituting calendar year #bjjc for calendar year #bjaf in subparagraph 7,a77ii7 thereof4 1 and 7,c7 by striking 7b77#b71 7c77#a77;,e77ii77,,ii71 and inserting 7c77#a77;,e77ii77,,ii74 7#c7 ,section #bf7;b77#b77,s7 of such ,code is amended by striking 1 #bbc7;b77#h77;,b77i77,,ii714 7#d7 ,section #djh7;d77#i77;,c77i77,i7 of such ,code is amended by striking computed on the basis of the type of coverage under the high deductible health plan covering the individual4 7c7 ,effective date ,the amendments made by this section shall apply to taxable years beginning after the date of the enactment of this ,act4 #ajc4 ,freedom from mandate 7a7 ,in general ,section #bbc of the ,internal ,revenue ,code of #aihf1 as amended by section #ajb1 is further amended by striking subsections 7c7 and 7g7 and by redesignating subsections 7d71 7e71 7f71 and 7h7 as subsections 7c71 7d71 7e71 and 7f71 respectively4 7b7 ,conforming amendments 7#a7 ,subsection 7a7 of section #bbc of the ,internal ,revenue ,code of #aihf is amended to read as follows3 7a7 ,deduction allowed ,in the case of an individual1 there shall be allowed as a deduction for the taxable year an amount equal to the aggregate amount paid in cash during such taxable year by or on behalf of such individual to a health savings account of such individual4 4 7#b7 ,subsection 7c77#a77;,a7 of section #bbc of such ,code1 as amended by section #ajb and redesignated by subsection 7a71 is further amended by striking subsection 7f77#d7 and inserting subsection 7e77#d74 7#c7 ,subparagraph 7,u7 of section #bf7;b77#b7 of such ,code1 as amended by section #ajb1 is further amended by striking section #bbc7;f77#c7 and inserting section #bbc7;e77#c74 7#d7 ,sections #ce7;g77#c71 #bbj7;f77#e77;,a71 #hdh7;e77#a77;,b77v71 #digc7;a77#e71 and #fjea7;a77#ab7 of such ,code are each amended by striking section #bbc7;d7 each place it appears and inserting section #bbc7;c74 7#e7 ,section #ajf7;d77#a7 of such ,code is amended-- 7,a7 by striking who is an eligible individual 7as defined in section #bbc7;c77#a771 and 7,b7 by striking section #bbc7;d7 and inserting section #bbc7;c74 7#f7 ,section #ajf7;e7 of such ,code is amended-- 7,a7 by striking paragraphs 7#c7 and 7#d7 and by redesignating paragraph 7#e7 as paragraph 7#d71 7,b7 by inserting after paragraph 7#b7 the following new paragraph3 7#c7 ,treatment as rollover contribution ,a qualified ,,hsa distribution shall be treated as a rollover contribution described in section #bbc7;e77#d74 1 and 7,c7 by striking to any eligible individual covered under a high deductible health plan of the employer in paragraph 7#d77;,b77ii7 7as so redesignated7 and inserting to any employee with respect to whom a health savings account has been established4 7#g7 ,section #djh7;d77#i77;,a7 of such ,code is amended by striking who is an eligible individual 7as defined in section #bbc7;c77 and4 7#h7 ,section #hgg;,a7g77#f7 of such ,code is amended by striking #bbc7;f77#d7 and inserting #bbc7;e77#d74 7#i7 ,section #digc7;g7 of such ,code is amended-- 7,a7 by striking section #bbc7;d7 and inserting section #bbc7;c71 7,b7 in paragraph 7#a71 by striking or #bbc7;f77#e7 and inserting or #bbc7;e77#e71 7,c7 in paragraph 7#b77;,a71 by striking section #bbc7;f77#b7 and inserting section #bbc7;e77#b71 and 7,d7 in the flush matter at the end1 by striking section #bbc7;f77#c7 and inserting section #bbc7;e77#c74 7#aj7 ,section #dige of such ,code is amended-- 7,a7 in subsection 7c77#f7-- 7i7 by striking section #bbc7;d7 and inserting section #bbc7;c71 and 7ii7 by striking section #bbc7;e77#b7 and inserting section #bbc7;d77#b71 and 7,b7 in subsection 7e77#a77;,e71 by striking section #bbc7;d7 and inserting section #bbc7;c74 7#aa7 ,subsection 7b7 of section #dihj;,g of such ,code is amended to read as follows3 7b7 ,rules and requirements 7#a7 ,in general ,an employer meets the requirements of this subsection for any calendar year if the employer makes available comparable contributions to the health savings accounts of all comparable participating employees for each coverage period during such calendar year4 7#b7 ,comparable contributions 7,a7 ,in general ,for purposes of paragraph 7#a71 the term comparable contributions means contributions-- 7i7 which are the same amount1 or 7ii7 if the employees are covered by a health plan1 which are the same percentage of the annual deductible limit under the plan covering the employees4 7,b7 ,part-year employees ,in the case of an employee who is employed by the employer for only a portion of the calendar year1 a contribution to the health savings account of such employee shall be treated as comparable if it is an amount which bears the same ratio to the comparable amount 7determined without regard to this subparagraph7 as such portion bears to the entire calendar year4 7#c7 ,comparable participating employees ,for purposes of paragraph 7#a71 the term comparable participating employees means all employees who are covered 7if at all7 under the same health plan of the employer and have the same category of coverage4 ,for purposes of the preceding sentence1 the categories of coverage are self-only and family coverage4 7#d7 ,part-time employees 7,a7 ,in general ,paragraph 7#c7 shall be applied separately with respect to part-time employees and other employees4 7,b7 ,part-time employee ,for purposes of subparagraph 7,a71 the term part-time employee means any employee who is customarily employed for fewer than #cj hours per week4 4 7#ab7 ,section #dihj;,g7d7 of such ,code is amended by striking section #dihj;,e and inserting this section4 7#ac7 ,section #ffic7;a77#b77;,c7 of such ,code is amended by striking section #bbc7;h7 and inserting section #bbc7;f74 7c7 ,effective date ,the amendments made by this section shall apply to taxable years beginning after the date of the enactment of this ,act4 #ajd4 ,amounts paid for health insurance or direct primary care service arrangement 7a7 ,in general ,paragraph 7#b7 of section #bbc7;c7 of the ,internal ,revenue ,code of #aihf1 as redesignated by section #c1 is amended-- 7#a7 in subparagraph 7,a71 by inserting or pursuant to an arrangement under which an individual is provided coverage restricted to primary care services in exchange for a fixed periodic fee or payment for primary care services after menstrual care products1 7#b7 by striking subparagraphs 7,b7 and 7,c71 and 7#c7 by redesignating subparagraph 7,d7 as subparagraph 7,b74 7b7 ,conforming amendment ,paragraph 7#b7 of section #bbc7;c7 of the ,internal ,revenue ,code of #aihf1 as amended by the preceding sections of this ,act1 is further amended by striking and any dependent 7as defined in section #aeb1 determined without regard to subsections 7b77#a71 7b77#b71 and 7d77#a77;,b7 thereof7 of such individual and inserting any dependent 7as defined in section #aeb1 determined without regard to subsections 7b77#a71 7b77#b71 and 7d77#a77;,b7 thereof7 of such individual1 and any child 7as defined in section #aeb7;f77#a77 of such individual who has not attained the age of #bg before the end of such individual's taxable year4 7c7 ,technical amendments 7#a7 ,section #bbj7;d77#b77;,a7 of the ,internal ,revenue ,code of #aihf is amended by striking section #bbc7;d77#b77;,d7 and inserting section #bbc7;c77#b77;,b74 7#b7 ,subsection 7f7 of section #ajf of the ,internal ,revenue ,code of #aihf is amended by striking section #bbc7;d77#b77;,d7 and inserting section #bbc7;c77#b77;,b74 7d7 ,effective dates 7#a7 ,in general ,the amendments made by subsections 7a7 and 7b7 shall apply with respect to amounts paid after the date of the enactment of this ,act in taxable years beginning after such date4 7#b7 ,technical amendments ,the amendments made by subsection 7c7 shall apply with respect to taxable years beginning after the date of enactment of this ,act4 #aje4 ,special rule for certain medical expenses incurred before establishment of account 7a7 ,in general ,paragraph 7#b7 of section #bbc7;c7 of the ,internal ,revenue ,code of #aihf1 as amended and redesignated by the preceding sections of this ,act1 is further amended by adding at the end the following new subparagraph3 7,c7 ,certain medical expenses incurred before establishment of account treated as qualified ,an expense shall not fail to be treated as a qualified medical expense solely because such expense was incurred before the establishment of the health savings account if such expense was incurred-- 7i7 during either-- 7,i7 the taxable year in which the health savings account was established1 or 7,,ii7 the preceding taxable year1 in the case of a health savings account established after the taxable year in which such expense was incurred but before the time prescribed by law for filing the return for such taxable year 7not including extensions thereof71 and 7ii7 for medical care which 7but for the fact that it was incurred before the establishment of the account7 otherwise meets the requirements of the preceding subparagraphs4 4 7b7 ,effective date ,the amendment made by this section shall apply to taxable years beginning after the date of the enactment of this ,act4 #ajf4 ,administrative error correction before due date of return 7a7 ,in general ,paragraph 7#d7 of section #bbc7;e7 of the ,internal ,revenue ,code of #aihf1 as amended and redesignated by the preceding sections of this ,act1 is amended by adding at the end the following new subparagraph3 7,d7 ,exception for administrative errors corrected before due date of return ,subparagraph 7,a7 shall not apply if any payment or distribution is made to correct an administrative1 clerical1 or payroll contribution error and if-- 7i7 such distribution is received by the individual on or before the last day prescribed by law 7including extensions of time7 for filing such individual's return for such taxable year1 and 7ii7 such distribution is accompanied by the amount of net income attributable to such contribution4 ,any net income described in clause 7ii7 shall be included in the gross income of the individual for the taxable year in which it is received4 4 7b7 ,effective date ,the amendment made by this section shall take effect on the date of the enactment of this ,act4 #ajg4 ,allowing ,,hsa rollover to child or parent of account holder 7a7 ,in general ,paragraph 7#h77;,a7 of section #bbc7;e7 of the ,internal ,revenue ,code of #aihf1 as redesignated by the preceding sections of this ,act1 is amended-- 7#a7 by inserting 1 child1 parent1 or grandparent after surviving spouse1 7#b7 by inserting 1 child1 parent1 or grandparent1 as the case may be1 after the spouse1 7#c7 by inserting 1 child1 parent1 or grandparent after spouse in the heading thereof1 and 7#d7 by adding at the end the following3 ,in the case of a child who acquires such beneficiary's interest and with respect to whom a deduction under section #aea is allowable to another taxpayer for a taxable year beginning in the calendar year in which such individual's taxable year begins1 such health savings account shall be treated as a health savings account of such child44 7b7 ,effective date ,the amendments made by this section shall apply to taxable years beginning after the date of the enactment of this ,act4 #ajh4 ,coverage for amounts paid for vitamins1 dietary supplements1 gym memberships1 and wearable fitness trackers 7a7 ,in general ,paragraph 7#b7 of section #bbc7;c7 of the ,internal ,revenue ,code of #aihf1 as amended by the preceding provisions of this ,act1 is amended-- 7#a7 in subparagraph 7,a71 by inserting 1 qualified wellness expenses1 after menstrual care products1 and 7#b7 by adding at the end the following3 7,c7 ,qualified wellness expenses ,for purposes of this paragraph1 the term qualified wellness expenses means amounts paid for-- 7i7 vitamins1 7ii7 dietary supplements 7as defined in section #bja7;ff7 of the ,federal ,food1 ,drug1 and ,cosmetic ,act 7#ba ,u4,s4,c4 #cba7;ff7771 7iii7 membership at a gym or fitness facility1 or 7iv7 wearable fitness trackers4 4 7b7 ,effective date ,the amendments made by this section shall apply to taxable years beginning after the date of the enactment of this ,act4 #aji4 ,equivalent bankruptcy protections for health savings accounts as retirement funds 7a7 ,in general ,section #ebb of title #aa1 ,united ,states ,code1 is amended by adding at the end the following new subsection3 7r7 ,treatment of health savings accounts ,for purposes of this section1 any health savings account 7as described in section #bbc of the ,internal ,revenue ,code of #aihf7 shall be treated in the same manner as an individual retirement account described in section #djh of such ,code4 4 7b7 ,effective date ,the amendment made by this section shall apply to cases commencing under title #aa1 ,united ,states ,code1 after the date of the enactment of this ,act4 ,,ii ,health ,marketplace for ,all #bja4 ,short title ,this title may be cited as the ,health ,marketplace for ,all ,act of #bjbe4 #bjb4 ,health marketplace pools deemed an employer for purposes of offering group health plans or group health insurance coverage 7a7 ,definition of employer ,section #c7e7 of the ,employee ,retirement ,income ,security ,act of #aigd 7#bi ,u4,s4,c4 #ajjb7e77 is amended by adding at the end the following3 ,such term shall be deemed to include1 for purposes of offering a group health plan 7as defined in section #gcc7;a77#a77 or group health insurance coverage 7as defined in section #gcc7;b77#d77 7which1 notwithstanding any other provision of law1 may include such a plan or coverage covering prescription or nonprescription drugs as the only benefit offered by the plan or coverage in accordance with section #gcf7;b77#e77;,b771 any entity that meets the requirements under section #gcf7;b744 7b7 ,group health plans and group health insurance coverage ,part #g of subtitle ,b of title ,i of the ,employee ,retirement ,income ,security ,act of #aigd 7#bi ,u4,s4,c4 #aaha et seq47 is amended by adding at the end the following3 #gcf4 ,health marketplace pools deemed an employer for purposes of offering group health plans or group health insurance coverage 7a7 ,in general ,an entity 7referred to in this section as a health marketplace pool7 that meets the requirements under subsection 7b7 shall be deemed an employer under section #c7e7 for purposes of offering a group health plan or group health insurance coverage 7which1 notwithstanding any other provision of law1 may include such a plan or coverage covering prescription or nonprescription drugs as the only benefit offered by the plan or coverage in accordance with subsection 7b77#e77;,b774 7b7 ,requirements for health marketplace pools ,the requirements under this subsection are each of the following3 7#a7 ,organization ,the health marketplace pool shall-- 7,a7 be formed and maintained in good faith for a purpose that includes the formation of a risk pool in order to offer group health insurance coverage or a group health plan to its members2 and 7,b7 not condition membership in the health marketplace pool on any health status-related factor relating to an individual 7including an employee of an employer or a dependent of an employee74 7#b7 ,offering group health plans and group health insurance coverage 7,a7 ,different groups 7i7 ,in general ,the health marketplace pool1 which may be in conjunction with a health insurance issuer that offers group health insurance coverage through the health marketplace pool1 shall make available a group health plan or group health insurance coverage to all members of the health marketplace pool 7and1 in the case of members that are employers1 employees of the employers7 at rates that-- 7,i7 are established by the health marketplace pool1 or a health insurance issuer contracting with such health marketplace pool1 on a policy or product specific basis2 and 7,,ii7 subject to sections #gja and #gjb1 may vary for individuals covered through the health marketplace pool4 7ii7 ,permissible coverage for dependents ,such group health plan or group health insurance coverage may be made available under clause 7i7 to any dependents of members of the health marketplace pool or dependents of employees of employers that are such members4 7,b7 ,nondiscrimination in coverage offered 7i7 ,in general ,subject to clause 7ii71 the health marketplace pool may not offer coverage under a group health plan or group health insurance coverage to a member of the health marketplace pool unless the same coverage is offered to all such members of the health marketplace pool4 7ii7 ,construction ,nothing in this subsection shall be construed as requiring a health insurance issuer or group health plan to provide coverage outside the service area of the issuer or plan1 or preventing a health insurance issuer or group health plan from underwriting or from excluding or limiting the coverage on any individual1 subject to the requirements under sections #gja and #gjb4 7,c7 ,assumption of risk ,the health marketplace pool may provide-- 7i7 group health insurance coverage through a contract with a health insurance issuer2 or 7ii7 a group health plan through self-insurance4 7#c7 ,geographic areas ,nothing in this subsection shall be construed as preventing the establishment and operation of more than #a health marketplace pool in a geographic area or as limiting the number of health marketplace pools that may operate in any area4 7#d7 ,provision of administrative services to purchasers ,the health marketplace pool may provide administrative services for members4 ,such services may include accounting1 billing1 and enrollment information4 7#e7 ,drug coverage ,the group health plan or group health insurance coverage offered by the health marketplace pool may offer-- 7,a7 drug coverage1 including coverage of over-the-counter drugs1 in combination with other benefits covered by the group health plan or group health insurance coverage2 or 7,b7 notwithstanding any other provision of law1 drug coverage1 including coverage of over-the-counter drugs1 as the only benefit covered by the group health plan or group health insurance coverage4 7#f7 ,members 7,a7 ,in general ,with respect to an individual who is a member of the health marketplace pool-- 7i7 the individual may enroll for coverage under the group health plan or group health insurance coverage offered by the health marketplace pool 7including1 if applicable1 enrollment for coverage for a dependent of such individual72 or 7ii7 the employer of the individual may enroll the individual for coverage under the group health plan or group health insurance coverage offered by the health marketplace pool 7including1 if applicable1 enrollment for coverage for a dependent of such individual74 7,b7 ,eligibility ,an individual shall be eligible to be a member of the health marketplace pool if such individual is-- 7i7 a member of an entity that establishes or joins the health marketplace pool 7or a dependent of such a member1 as applicable72 7ii7 an employee of a member of an entity described in clause 7i7 7or a dependent of such an employee1 as applicable72 or 7iii7 an employee of an entity 7or a dependant of such an employee1 as applicable7 controlled by a member of an entity described in clause 7i74 7,c7 ,rules for enrollment ,nothing in this paragraph shall preclude the health marketplace pool from establishing rules of enrollment and reenrollment of members4 ,such rules shall be applied consistently to all members within the health marketplace pool and shall not be based in any manner on health status-related factors in accordance with sections #gja and #gjb4 7c7 ,determination of employer and joint employer status ,participating in or facilitating a group health plan or group health insurance coverage under this section shall not be construed as establishing under any ,federal or ,state law-- 7#a7 an employer relationship for any purpose other than offering the group health plan or group health insurance coverage2 or 7#b7 a joint employer relationship for any purpose4 7d7 ,definition ,in this section1 the term dependent1 as applied to a group health plan or group health insurance coverage offered in a ,state1 shall have the meaning applied to such term with respect to such plan or coverage under the ,state law applying to such plan or coverage4 ,such term may include the spouse and children of the individual involved in accordance with such ,state law4 4 #bjc4 ,conforming amendments ,section #c of the ,employee ,retirement ,income ,security ,act of #aigd 7#bi ,u4,s4,c4 #ajjb7 is amended-- 7#a7 in paragraph 7#f71 by inserting before the period 1 except 7with respect to an entity meeting the requirements under section #gcf7;b77 such term includes any member of such entity2 7#b7 in paragraph 7#ba7-- 7,a7 in subparagraph 7,a71 by striking subparagraph 7,b7 and inserting subparagraphs 7,b7 and 7,c72 and 7,b7 by adding at the end the following3 7,c7 ,with respect to a person that is a member of an entity 7referred to in section #gcf and this subparagraph as a health marketplace pool7 that meets the requirements of section #gcf7;b7 and offers a group health plan 7as defined in section #gcc7;a77#a77 or group health insurance coverage 7as defined in section #gcc7;b77#d77 7which1 notwithstanding any other provision of law1 may include such a plan or coverage covering prescription or nonprescription drugs as the only benefit offered by the plan or coverage71 membership in the health marketplace pool shall not by itself cause the person to be a fiduciary with respect to the group health plan or group health insurance coverage4 2 and 7#c7 in paragraph 7#dj77;,a7-- 7,a7 in clause 7ii71 by striking 1 or and inserting 12 7,b7 in clause 7iii71 by striking the period and inserting 1 or2 and 7,c7 by adding at the end the following3 7iv7 as a group health plan 7as defined in section #gcc7;a77#a771 or group health insurance coverage 7as defined in section #gcc7;b77#d771 offered by an entity meeting the requirements under section #gcf7;b7 7which1 notwithstanding any other provision of law1 may include such an entity offering such a plan or coverage covering prescription or nonprescription drugs as the only benefit offered by the plan or coverage74 4