I 

116TH CONGRESS 

2D SESSION H. R. 5596 

To amend the Internal Revenue Code of 1986 to expand and improve health 

savings accounts, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

JANUARY 14, 2020 

Mr. ROY (for himself, Mr. BIGGS, and Mr. JOHNSON of Louisiana) introduced 

the following bill; which was referred to the Committee on Ways and Means 

A BILL 

To amend the Internal Revenue Code of 1986 to expand 

and improve health savings accounts, and for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Personalized Care Act 

5 of 2020’’. 

6 SEC. 2. HEALTH SAVINGS ACCOUNT ELIGIBILITY. 

7 (a) IN GENERAL.—Paragraph (1) of section 223(c) 

8 of the Internal Revenue Code of 1986 is amended to read 

9 as follows: 


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1 ‘‘(1) ELIGIBLE INDIVIDUAL.—The term ‘eligible 

2 individual’ means, with respect to any month, any 

3 individual if such individual is— 

4 ‘‘(A) covered under— 

5 ‘‘(i) a group or individual health plan, 

6 ‘‘(ii) health insurance coverage, in7 cluding a short term limited duration plan 

8 or medical indemnity plan, or 

9 ‘‘(iii) a government plan, including 

10 coverage under the Medicare program 

11 under part A or part B of title XVIII of 

12 the Social Security Act, the Medicaid pro13 gram under title XIX of such Act, the 

14 CHIP program under title XXI of such 

15 Act or a qualified CHIP look-alike pro16 gram (as defined in section 2107(g) of 

17 such Act), medical coverage under chapter 

18 55 of title 10, United States Code (includ19 ing coverage under the TRICARE pro20 gram), a health care program under chap21 ter 17 or 18 of title 38, United States 

22 Code, as determined by the Secretary of 

23 Veterans Affairs in coordination with the 

24 Secretary of Health and Human Services 

25 and the Secretary, a medical care program 


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1 of the Indian Health Service or a tribal or2 ganization, or coverage under chapter 89 

3 of title 5, United States Code, or 

4 ‘‘(B) a participant in a health care sharing 

5 ministry (as defined in section 

6 5000A(d)(2)(B)(ii)), 

7 as of the 1st day of such month.’’. 

8 (b) CONFORMING AMENDMENTS.— 

9 (1) Subsection (c) of section 223 of such Code 

10 is amended by striking paragraphs (2) and (3) and 

11 by redesignating paragraphs (4) and (5) as para12 graphs (2) and (3), respectively. 

13 (2) Paragraphs (2)(A) and (2)(B) of section 

14 223(b) of such Code are each amended by striking 

15 ‘‘a high deductible health plan’’ and inserting ‘‘a 

16 health plan, insurance, or ministry described in sub17 section (c)(1)’’. 

18 (3) Paragraph (8)(A)(ii) of section 223(b) of 

19 such Code is amended by striking ‘‘high deductible 

20 health plan’’ and inserting ‘‘health plan, insurance, 

21 or ministry described in subsection (c)(1)’’. 

22 (4) Section 223(g)(1) of such Code is amend23 ed— 


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1 (A) by striking ‘‘subsections (b)(2) and 

2 (c)(2)(A)’’ both places it appears and inserting 

3 ‘‘subsection (b)(2)’’, and 

4 (B) by striking ‘‘for ‘calendar year 2016’ ’’ 

5 in subparagraph (B) and all that follows 

6 through ‘‘ ‘calendar year 2003’.’’ and inserting 

7 ‘‘ ‘calendar year 1997’ for ‘calendar year 2016’ 

8 in subparagraph (A)(ii) thereof.’’. 

9 (5) The heading of subparagraph (B) of section 

10 223(b)(8) of such Code is amended by striking 

11 ‘‘HIGH DEDUCTIBLE HEALTH PLAN’’. 

12 (6) Section 26(b)(2)(S) of such Code is amend13 ed by striking ‘‘high deductible health plan’’. 

14 (7) The heading of paragraph (3) of section 

15 106(e) of such Code is amended by striking ‘‘HIGH

16 DEDUCTIBLE HEALTH PLAN’’. 

17 (8) Clause (ii) of section 106(e)(5)(B) of such 

18 Code is amended by striking ‘‘a high deductible 

19 health plan’’ and inserting ‘‘a health plan’’. 

20 (9) Paragraph (9) of section 408(d) of such 

21 Code is amended— 

22 (A) by striking ‘‘the high deductible health 

23 plan covering’’ in subparagraph (C)(i)(I) and 

24 inserting ‘‘health plan, insurance, or ministry 

25 of’’, 


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1 (B) by striking ‘‘a high deductible health 

2 plan’’ the first place it appears in subparagraph 

3 (C)(ii)(II) and inserting ‘‘a health plan, insur4 ance, or ministry described in section 

5 223(c)(1)’’, 

6 (C) by striking ‘‘a high deductible health 

7 plan’’ the second place it appears in subpara8 graph (C)(ii)(II) and inserting ‘‘any such plan, 

9 insurance, or ministry’’, and 

10 (D) by striking ‘‘HIGH DEDUCTIBLE

11 HEALTH PLAN’’ in the heading of subparagraph 

12 (D). 

13 (c) EFFECTIVE DATE.—The amendments made by 

14 this section shall apply to taxable years beginning after 

15 December 31, 2019. 

16 SEC. 3. INCREASE IN HSA CONTRIBUTION LIMITS. 

17 (a) IN GENERAL.—Paragraph (2) of section 223(b) 

18 of the Internal Revenue Code of 1986 is amended— 

19 (1) by striking ‘‘$2,250’’ in subparagraph (A) 

20 and inserting ‘‘$10,800’’, and 

21 (2) by striking ‘‘$4,500’’ in subparagraph (B) 

22 and inserting ‘‘$29,500’’. 

23 (b) COST-OF-LIVING ADJUSTMENT.—Paragraph (1) 

24 of section 223(g) of the Internal Revenue Code of 1986, 

25 as amended by section 2, is amended— 


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1 (1) by striking ‘‘Each’’ and inserting ‘‘In the 

2 case of a taxable year beginning after 2020, each’’, 

3 and 

4 (2) by striking ‘‘calendar year 1997’’ and in5 serting ‘‘calendar year 2019’’. 

6 (c) EFFECTIVE DATE.—The amendments made by 

7 this section shall apply to taxable years beginning after 

8 December 31, 2019. 

9 SEC. 4. PAYMENT OF HEALTH PLAN AND HEALTH INSUR10 ANCE PREMIUMS FROM HSA. 

11 (a) IN GENERAL.—Paragraph (2) of section 223(d) 

12 of the Internal Revenue Code of 1986 is amended— 

13 (1) by striking subparagraph (B), 

14 (2) by redesignating subparagraph (C) as sub15 paragraph (B), 

16 (3) by striking ‘‘Subparagraph (B) shall not 

17 apply to any expense for coverage under’’ in sub18 paragraph (B), as so redesignated, and inserting 

19 ‘‘Subparagraph (A) shall not apply to any payment 

20 for insurance other than’’, and 

21 (4) in subparagraph (B), as so redesignated— 

22 (A) by striking ‘‘or’’ at the end of clause 

23 (iii), 

24 (B) by striking the period at the end of 

25 clause (iv) and inserting ‘‘, or’’, and 


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1 (C) by adding at the end the following new 

2 clause: 

3 ‘‘(v) a health plan or health insurance 

4 coverage described in subsection 

5 (c)(1)(A).’’. 

6 (b) EFFECTIVE DATE.—The amendments made by 

7 this section shall apply to taxable years beginning after 

8 December 31, 2019. 

9 SEC. 5. TREATMENT OF MEDICAL CARE SERVICE ARRANGE10 MENTS. 

11 (a) INCLUSION AS MEDICAL EXPENSES.—Paragraph 

12 (2) of section 223(d) of the Internal Revenue Code of 

13 1986, as amended by section 4, is further amended by 

14 adding at the end the following new subparagraph: 

15 ‘‘(C) INCLUSION OF MEDICAL CARE SERV16 ICE ARRANGEMENTS.—The term ‘qualified med17 ical expenses’ shall include— 

18 ‘‘(i) periodic fees paid to a physician 

19 for a defined set of medical services or for 

20 the right to receive medical services on an 

21 as-needed basis, and 

22 ‘‘(ii) amounts prepaid for medical 

23 services designed to screen for, diagnose, 

24 cure, mitigate, treat, or prevent disease 

25 and promote wellness.’’. 


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1 (b) ARRANGEMENT NOT TO BE TREATED AS

2 HEALTH INSURANCE.—Subsection (c) of section 223 of 

3 the Internal Revenue Code of 1986, as amended by section 

4 2(b), is further amended by adding at the end the fol5 lowing new paragraph: 

6 ‘‘(4) TREATMENT OF MEDICAL CARE SERVICE

7 ARRANGEMENTS.—An arrangement under which an 

8 individual is provided medical services in exchange 

9 for a fixed periodic fee or payment for such services 

10 shall not be treated as a health plan, insurance, or 

11 arrangement described in paragraph (1).’’. 

12 (c) EFFECTIVE DATE.—The amendments made by 

13 this section shall apply to taxable years beginning after 

14 December 31, 2019. 

15 SEC. 6. PERIODIC PROVIDER FEES TREATED AS MEDICAL 

16 CARE. 

17 (a) IN GENERAL.—Section 213(d) of the Internal 

18 Revenue Code of 1986 is amended by adding at the end 

19 the following new paragraph: 

20 ‘‘(12) PERIODIC PROVIDER FEES.—Periodic 

21 fees paid for a defined set of medical services pro22 vided on an as-needed basis shall be treated as 

23 amounts paid for medical care.’’. 


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1 (b) EFFECTIVE DATE.—The amendment made by 

2 this section shall apply to taxable years beginning after 

3 December 31, 2019. 

4 SEC. 7. EXPANDING OVER-THE-COUNTER DRUG COVERAGE 

5 AND RESTORING LOWER PENALTY FOR NON6 QUALIFIED DISTRIBUTIONS. 

7 (a) OVER-THE-COUNTER COVERAGE.—Section 

8 223(d)(2)(A) of the Internal Revenue Code of 1986 is 

9 amended by striking the last sentence and inserting the 

10 following: ‘‘Such term shall include an amount paid for 

11 any prescription or over-the-counter medicine or drug.’’. 

12 (b) PENALTY.—Section 223(e)(4)(A) of the Internal 

13 Revenue Code of 1986 is amended by striking ‘‘20 per14 cent’’ and inserting ‘‘10 percent’’. 

15 (c) EFFECTIVE DATE.—The amendments made by 

16 this section shall apply to distributions made in taxable 

17 years beginning after December 31, 2019. 

18 SEC. 8. TREATMENT OF HEALTH CARE SHARING MIN19 ISTRIES. 

20 (a) INCLUSION AS MEDICAL EXPENSES.—Paragraph 

21 (2) of section 223(d) of the Internal Revenue Code of 

22 1986, as amended by sections 4 and 5, is further amended 

23 by adding at the end the following new subparagraph: 

24 ‘‘(D) INCLUSION OF HEALTH CARE SHAR25 ING MINISTRIES.—The term ‘qualified medical 


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1 expenses’ shall include amounts paid by a mem2 ber of a health care sharing ministry (as de3 fined in section 5000A(d)(2)(B)(ii)) for— 

4 ‘‘(i) the sharing of medical expenses 

5 among members, and 

6 ‘‘(ii) administrative fees of the min7 istry.’’. 

8 (b) HEALTH CARE SHARING MINISTRY NOT TO BE

9 TREATED AS HEALTH INSURANCE.—Subsection (c) of 

10 section 223 of the Internal Revenue Code of 1986, as 

11 amended by sections 2 and 5, is further amended by add12 ing at the end the following new paragraph: 

13 ‘‘(5) TREATMENT OF HEALTH CARE SHARING

14 MINISTRIES.—A health care sharing ministry (as de15 fined in section 5000A(d)(2)(B)(ii)) shall not be 

16 treated as a health plan or insurance for purposes 

17 of this title.’’. 

18 (c) EFFECTIVE DATE.—The amendments made by 

19 this section shall apply to taxable years beginning after 

20 December 31, 2019. 

Æ 


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