II 

118TH CONGRESS 

2D SESSION S. 5297 

To amend the Internal Revenue Code of 1986 to increase the limitations 

on contributions to health savings accounts, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

NOVEMBER 12, 2024 

Mr. PAUL introduced the following bill; which was read twice and referred to 

the Committee on Finance 

A BILL 

To amend the Internal Revenue Code of 1986 to increase 

the limitations on contributions to 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 ‘‘Health Savings Ac5 counts For All Act of 2024’’. 

6 SEC. 2. INCREASE IN CONTRIBUTION LIMITATIONS. 

7 (a) IN GENERAL.—Subsection (b) of section 223 of 

8 the Internal Revenue Code of 1986 is amended— 

9 (1) in paragraph (1), by striking ‘‘the sum of’’ 

10 and all that follows through the period and inserting 


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1 ‘‘an amount equal to the applicable dollar amount 

2 under paragraph (1)(B) of section 402(g) (as ad3 justed pursuant to paragraph (4) of such section) 

4 with respect to such taxable year.’’, 

5 (2) by striking paragraphs (2), (3), (5), (7), 

6 and (8), 

7 (3) by inserting after paragraph (1) the fol8 lowing: 

9 ‘‘(2) ADDITIONAL CONTRIBUTIONS FOR INDI10 VIDUALS 50 OR OLDER.—In the case of an individual 

11 who has attained age 50 before the close of the tax12 able year, the amount of the limitation under para13 graph (1) shall be increased by an amount equal to 

14 the applicable dollar amount under subparagraph 

15 (B)(i) of section 414(v)(2) (as adjusted pursuant to 

16 subparagraph (C) of such section).’’, 

17 (4) in paragraph (4), by striking the flush mat18 ter following subparagraph (C), and 

19 (5) by redesignating paragraphs (4) and (6) as 

20 paragraphs (3) and (4), respectively. 

21 (b) CONFORMING AMENDMENTS.— 

22 (1) Subparagraph (A) of section 223(d)(1) of 

23 the Internal Revenue Code of 1986 is amended by 

24 striking ‘‘the sum of—’’ and all that follows through 


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1 the period and inserting ‘‘the amount determined 

2 under subsection (b)(1).’’. 

3 (2) Subsection (g) of section 223 of such Code 

4 is amended— 

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

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

7 ‘‘subsection (c)(2)(A)’’, and 

8 (B) by amending subparagraph (B) to read 

9 as follows: 

10 ‘‘(B) the cost-of-living adjustment deter11 mined under section 1(f)(3) for the calendar 

12 year in which such taxable year begins deter13 mined by substituting ‘calendar year 2003’ for 

14 ‘calendar year 2016’ in subparagraph (A)(ii) 

15 thereof.’’. 

16 (3) Section 26(b)(2)(S) of such Code is amend17 ed by striking ‘‘, 223(b)(8)(B)(i)(II),’’. 

18 (4) Section 408(d)(9)(C)(i)(I) of such Code is 

19 amended by striking ‘‘computed on the basis of the 

20 type of coverage under the high deductible health 

21 plan covering the individual’’. 

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

23 this section shall apply to taxable years beginning after 

24 the date of the enactment of this Act. 


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1 SEC. 3. FREEDOM FROM MANDATE. 

2 (a) IN GENERAL.—Section 223 of the Internal Rev3 enue Code of 1986, as amended by section 2, is further 

4 amended by striking subsections (c) and (g) and by redes5 ignating subsections (d), (e), (f), and (h) as subsections 

6 (c), (d), (e), and (f), respectively. 

7 (b) CONFORMING AMENDMENTS.— 

8 (1) Subsection (a) of section 223 of the Inter9 nal Revenue Code of 1986 is amended to read as fol10 lows: 

11 ‘‘(a) DEDUCTION ALLOWED.—In the case of an indi12 vidual, there shall be allowed as a deduction for the tax13 able year an amount equal to the aggregate amount paid 

14 in cash during such taxable year by or on behalf of such 

15 individual to a health savings account of such individual.’’. 

16 (2) Subsection (c)(1)(A) of section 223 of such 

17 Code, as amended by section 2 and redesignated by 

18 subsection (a), is further amended by striking ‘‘sub19 section (f)(4)’’ and inserting ‘‘subsection (e)(4)’’. 

20 (3) Subparagraph (U) of section 26(b)(2) of 

21 such Code, as amended by section 2, is further 

22 amended by striking ‘‘section 223(f)(3)’’ and insert23 ing ‘‘section 223(e)(3)’’. 

24 (4) Sections 35(g)(3), 220(f)(5)(A), 

25 848(e)(1)(B)(v), 4973(a)(5), and 6051(a)(12) of 

26 such Code are each amended by striking ‘‘section 


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1 223(d)’’ each place it appears and inserting ‘‘section 

2 223(c)’’. 

3 (5) Section 106(d)(1) of such Code is amend4 ed— 

5 (A) by striking ‘‘who is an eligible indi6 vidual (as defined in section 223(c)(1))’’, and 

7 (B) by striking ‘‘section 223(d)’’ and in8 serting ‘‘section 223(c)’’. 

9 (6) Section 106(e) of such Code is amended— 

10 (A) by striking paragraphs (3) and (4) and 

11 by redesignating paragraph (5) as paragraph 

12 (4), 

13 (B) by inserting after paragraph (2) the 

14 following new paragraph: 

15 ‘‘(3) TREATMENT AS ROLLOVER CONTRIBU16 TION.—A qualified HSA distribution shall be treated 

17 as a rollover contribution described in section 

18 223(e)(4).’’, and 

19 (C) by striking ‘‘to any eligible individual 

20 covered under a high deductible health plan of 

21 the employer’’ in paragraph (4)(B)(ii) (as so re22 designated) and inserting ‘‘to any employee 

23 with respect to whom a health savings account 

24 has been established’’. 


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1 (7) Section 408(d)(9)(A) of such Code is 

2 amended by striking ‘‘who is an eligible individual 

3 (as defined in section 223(c)) and’’. 

4 (8) Section 877A(g)(6) of such Code is amend5 ed by striking ‘‘223(f)(4)’’ and inserting 

6 ‘‘223(e)(4)’’. 

7 (9) Section 4973(g) of such Code is amended— 

8 (A) by striking ‘‘section 223(d)’’ and in9 serting ‘‘section 223(c)’’, 

10 (B) in paragraph (1), by striking ‘‘or 

11 223(f)(5)’’ and inserting ‘‘or 223(e)(5)’’, 

12 (C) in paragraph (2)(A), by striking ‘‘sec13 tion 223(f)(2)’’ and inserting ‘‘section 

14 223(e)(2)’’, and 

15 (D) in the flush matter at the end, by 

16 striking ‘‘section 223(f)(3)’’ and inserting ‘‘sec17 tion 223(e)(3)’’. 

18 (10) Section 4975 of such Code is amended— 

19 (A) in subsection (c)(6)— 

20 (i) by striking ‘‘section 223(d)’’ and 

21 inserting ‘‘section 223(c)’’, and 

22 (ii) by striking ‘‘section 223(e)(2)’’ 

23 and inserting ‘‘section 223(d)(2)’’, and 


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1 (B) in subsection (e)(1)(E), by striking 

2 ‘‘section 223(d)’’ and inserting ‘‘section 

3 223(c)’’. 

4 (11) Subsection (b) of section 4980G of such 

5 Code is amended to read as follows: 

6 ‘‘(b) RULES AND REQUIREMENTS.— 

7 ‘‘(1) IN GENERAL.—An employer meets the re8 quirements of this subsection for any calendar year 

9 if the employer makes available comparable con10 tributions to the health savings accounts of all com11 parable participating employees for each coverage 

12 period during such calendar year. 

13 ‘‘(2) COMPARABLE CONTRIBUTIONS.— 

14 ‘‘(A) IN GENERAL.—For purposes of para15 graph (1), the term ‘comparable contributions’ 

16 means contributions— 

17 ‘‘(i) which are the same amount, or 

18 ‘‘(ii) if the employees are covered by a 

19 health plan, which are the same percentage 

20 of the annual deductible limit under the 

21 plan covering the employees. 

22 ‘‘(B) PART-YEAR EMPLOYEES.—In the 

23 case of an employee who is employed by the em24 ployer for only a portion of the calendar year, 

25 a contribution to the health savings account of 


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1 such employee shall be treated as comparable if 

2 it is an amount which bears the same ratio to 

3 the comparable amount (determined without re4 gard to this subparagraph) as such portion 

5 bears to the entire calendar year. 

6 ‘‘(3) COMPARABLE PARTICIPATING EMPLOY7 EES.—For purposes of paragraph (1), the term 

8 ‘comparable participating employees’ means all em9 ployees who are covered (if at all) under the same 

10 health plan of the employer and have the same cat11 egory of coverage. For purposes of the preceding 

12 sentence, the categories of coverage are self-only and 

13 family coverage. 

14 ‘‘(4) PART-TIME EMPLOYEES.— 

15 ‘‘(A) IN GENERAL.—Paragraph (3) shall 

16 be applied separately with respect to part-time 

17 employees and other employees. 

18 ‘‘(B) PART-TIME EMPLOYEE.—For pur19 poses of subparagraph (A), the term ‘part-time 

20 employee’ means any employee who is custom21 arily employed for fewer than 30 hours per 

22 week.’’. 

23 (12) Section 4980G(d) of such Code is amended 

24 by striking ‘‘section 4980E’’ and inserting ‘‘this sec25 tion’’. 


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1 (13) Section 6693(a)(2)(C) of such Code is 

2 amended by striking ‘‘section 223(h)’’ and inserting 

3 ‘‘section 223(f)’’. 

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

5 this section shall apply to taxable years beginning after 

6 the date of the enactment of this Act. 

7 SEC. 4. AMOUNTS PAID FOR HEALTH INSURANCE OR DI8 RECT PRIMARY CARE SERVICE ARRANGE9 MENT. 

10 (a) IN GENERAL.—Paragraph (2) of section 223(c) 

11 of the Internal Revenue Code of 1986, as redesignated by 

12 section 3, is amended— 

13 (1) in subparagraph (A), by inserting ‘‘or pur14 suant to an arrangement under which an individual 

15 is provided coverage restricted to primary care serv16 ices in exchange for a fixed periodic fee or payment 

17 for primary care services’’ after ‘‘menstrual care 

18 products’’, 

19 (2) by striking subparagraphs (B) and (C), and 

20 (3) by redesignating subparagraph (D) as sub21 paragraph (B). 

22 (b) CONFORMING AMENDMENT.—Paragraph (2) of 

23 section 223(c) of the Internal Revenue Code of 1986, as 

24 amended by the preceding sections of this Act, is further 

25 amended by striking ‘‘and any dependent (as defined in 


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1 section 152, determined without regard to subsections 

2 (b)(1), (b)(2), and (d)(1)(B) thereof) of such individual’’ 

3 and inserting ‘‘any dependent (as defined in section 152, 

4 determined without regard to subsections (b)(1), (b)(2), 

5 and (d)(1)(B) thereof) of such individual, and any child 

6 (as defined in section 152(f)(1)) of such individual who 

7 has not attained the age of 27 before the end of such indi8 vidual’s taxable year’’. 

9 (c) TECHNICAL AMENDMENTS.— 

10 (1) Section 220(d)(2)(A) of the Internal Rev11 enue Code of 1986 is amended by striking ‘‘section 

12 223(d)(2)(D)’’ and inserting ‘‘section 223(c)(2)(B)’’. 

13 (2) Subsection (f) of section 106 of the Internal 

14 Revenue Code of 1986 is amended by striking ‘‘sec15 tion 223(d)(2)(D)’’ and inserting ‘‘section 

16 223(c)(2)(B)’’. 

17 (d) EFFECTIVE DATES.— 

18 (1) IN GENERAL.—The amendments made by 

19 subsections (a) and (b) shall apply with respect to 

20 amounts paid after the date of the enactment of this 

21 Act in taxable years beginning after such date. 

22 (2) TECHNICAL AMENDMENTS.—The amend23 ments made by subsection (c) shall apply with re24 spect to taxable years beginning after the date of en25 actment of this Act. 


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1 SEC. 5. SPECIAL RULE FOR CERTAIN MEDICAL EXPENSES 

2 INCURRED BEFORE ESTABLISHMENT OF AC3 COUNT. 

4 (a) IN GENERAL.—Paragraph (2) of section 223(c) 

5 of the Internal Revenue Code of 1986, as amended and 

6 redesignated by the preceding sections of this Act, is fur7 ther amended by adding at the end the following new sub8 paragraph: 

9 ‘‘(C) CERTAIN MEDICAL EXPENSES IN10 CURRED BEFORE ESTABLISHMENT OF ACCOUNT

11 TREATED AS QUALIFIED.—An expense shall not 

12 fail to be treated as a qualified medical expense 

13 solely because such expense was incurred before 

14 the establishment of the health savings account 

15 if such expense was incurred— 

16 ‘‘(i) during either— 

17 ‘‘(I) the taxable year in which the 

18 health savings account was estab19 lished, or 

20 ‘‘(II) the preceding taxable year, 

21 in the case of a health savings ac22 count established after the taxable 

23 year in which such expense was in24 curred but before the time prescribed 

25 by law for filing the return for such 


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1 taxable year (not including extensions 

2 thereof), and 

3 ‘‘(ii) for medical care which (but for 

4 the fact that it was incurred before the es5 tablishment of the account) otherwise 

6 meets the requirements of the preceding 

7 subparagraphs.’’. 

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

9 this section shall apply to taxable years beginning after 

10 the date of the enactment of this Act. 

11 SEC. 6. ADMINISTRATIVE ERROR CORRECTION BEFORE 

12 DUE DATE OF RETURN. 

13 (a) IN GENERAL.—Paragraph (4) of section 223(e) 

14 of the Internal Revenue Code of 1986, as amended and 

15 redesignated by the preceding sections of this Act, is 

16 amended by adding at the end the following new subpara17 graph: 

18 ‘‘(D) EXCEPTION FOR ADMINISTRATIVE

19 ERRORS CORRECTED BEFORE DUE DATE OF RE20 TURN.—Subparagraph (A) shall not apply if 

21 any payment or distribution is made to correct 

22 an administrative, clerical, or payroll contribu23 tion error and if— 

24 ‘‘(i) such distribution is received by 

25 the individual on or before the last day 


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1 prescribed by law (including extensions of 

2 time) for filing such individual’s return for 

3 such taxable year, and 

4 ‘‘(ii) such distribution is accompanied 

5 by the amount of net income attributable 

6 to such contribution. 

7 Any net income described in clause (ii) shall be 

8 included in the gross income of the individual 

9 for the taxable year in which it is received.’’. 

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

11 this section shall take effect on the date of the enactment 

12 of this Act. 

13 SEC. 7. ALLOWING HSA ROLLOVER TO CHILD OR PARENT 

14 OF ACCOUNT HOLDER. 

15 (a) IN GENERAL.—Paragraph (8)(A) of section 

16 223(e) of the Internal Revenue Code of 1986, as redesig17 nated by the preceding sections of this Act, is amended— 

18 (1) by inserting ‘‘, child, parent, or grand19 parent’’ after ‘‘surviving spouse’’, 

20 (2) by inserting ‘‘, child, parent, or grand21 parent, as the case may be,’’ after ‘‘the spouse’’, 

22 (3) by inserting ‘‘, CHILD, PARENT, OR GRAND23 PARENT’’ after ‘‘SPOUSE’’ in the heading thereof, 

24 and 


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1 (4) by adding at the end the following: ‘‘In the 

2 case of a child who acquires such beneficiary’s inter3 est and with respect to whom a deduction under sec4 tion 151 is allowable to another taxpayer for a tax5 able year beginning in the calendar year in which 

6 such individual’s taxable year begins, such health 

7 savings account shall be treated as a health savings 

8 account of such child.’’. 

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

10 this section shall apply to taxable years beginning after 

11 the date of the enactment of this Act. 

12 SEC. 8. COVERAGE FOR AMOUNTS PAID FOR VITAMINS, DI13 ETARY SUPPLEMENTS, GYM MEMBERSHIPS, 

14 AND WEARABLE FITNESS TRACKERS. 

15 (a) IN GENERAL.—Paragraph (2) of section 223(c) 

16 of the Internal Revenue Code of 1986, as amended by the 

17 preceding provisions of this Act, is amended— 

18 (1) in subparagraph (A), by inserting ‘‘, quali19 fied wellness expenses,’’ after ‘‘menstrual care prod20 ucts’’, and 

21 (2) by adding at the end the following: 

22 ‘‘(C) QUALIFIED WELLNESS EXPENSES.— 

23 For purposes of this paragraph, the term 

24 ‘qualified wellness expenses’ means amounts 

25 paid for— 


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1 ‘‘(i) vitamins, 

2 ‘‘(ii) dietary supplements (as defined 

3 in section 201(ff) of the Federal Food, 

4 Drug, and Cosmetic Act (21 U.S.C. 

5 321(ff))), 

6 ‘‘(iii) membership at a gym or fitness 

7 facility, or 

8 ‘‘(iv) wearable fitness trackers.’’. 

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

10 this section shall apply to taxable years beginning after 

11 the date of the enactment of this Act. 

12 SEC. 9. EQUIVALENT BANKRUPTCY PROTECTIONS FOR 

13 HEALTH SAVINGS ACCOUNTS AS RETIRE14 MENT FUNDS. 

15 (a) IN GENERAL.—Section 522 of title 11, United 

16 States Code, is amended by adding at the end the fol17 lowing new subsection: 

18 ‘‘(r) TREATMENT OF HEALTH SAVINGS AC19 COUNTS.—For purposes of this section, any health savings 

20 account (as described in section 223 of the Internal Rev21 enue Code of 1986) shall be treated in the same manner 

22 as an individual retirement account described in section 

23 408 of such Code.’’. 

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

25 this section shall apply to cases commencing under title 


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1 11, United States Code, after the date of the enactment 

2 of this Act. 

Æ 


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