I 

116TH CONGRESS 

1ST SESSION H. R. 2878 

To amend the Internal Revenue Code of 1986 to allow qualified distributions 

from health savings accounts for certain home care expenses. 

IN THE HOUSE OF REPRESENTATIVES 

MAY 21, 2019 

Ms. PORTER (for herself, Mr. SMITH of Nebraska, Mr. LARSON of Connecticut, and Mrs. WALORSKI) 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 allow qualified distributions from health savings accounts for certain home care expenses. 

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 ‘‘Homecare for Seniors 

5 Act’’. 


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1 SEC. 2. CERTAIN HOME CARE EXPENSES TREATED AS 

2 QUALIFIED DISTRIBUTIONS FROM HEALTH 

3 SAVINGS ACCOUNTS. 

4 (a) IN GENERAL.—Section 223(d)(2) of the Internal 

5 Revenue Code of 1986 is amended— 

6 (1) by striking ‘‘medical care (as defined in sec7 tion 213(d)’’ in subparagraph (A) and inserting 

8 ‘‘specified medical care (as defined in subparagraph 

9 (D))’’; and 

10 (2) by adding at the end the following new sub11 paragraph: 

12 ‘‘(D) SPECIFIED MEDICAL CARE.—For 

13 purposes of this paragraph— 

14 ‘‘(i) IN GENERAL.—The term ‘speci15 fied medical care’ means— 

16 ‘‘(I) medical care (as defined in 

17 section 213(d)), and 

18 ‘‘(II) qualified home care. 

19 ‘‘(ii) QUALIFIED HOME CARE.—The 

20 term ‘qualified home care’ means a con21 tract to provide three or more of the fol22 lowing services in the residence of the serv23 ice recipient: 

24 ‘‘(I) Assistance with eating. 

25 ‘‘(II) Assistance with toileting. 


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1 ‘‘(III) Assistance with transfer2 ring. 

3 ‘‘(IV) Assistance with bathing. 

4 ‘‘(V) Assistance with dressing. 

5 ‘‘(VI) Assistance with continence. 

6 ‘‘(VII) Medication adherence. 

7 Such term shall not include any contract 

8 unless the services provided pursuant to 

9 such contract are provided by a service 

10 provider which is licensed by the State to 

11 provide such services or such services are 

12 otherwise provided in a manner that is 

13 consistent with State requirements. 

14 ‘‘(iii) RELATED PARTIES.—The term 

15 ‘qualified home care’ shall not include any 

16 contract which is, directly or indirectly, be17 tween a service provider and a service re18 cipient who are related within the meaning 

19 of section 267(b) or 707(b).’’. 

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

21 this section shall apply to amounts paid with respect to 

22 taxable years beginning after the date of the enactment 

23 of this Act. 

24 (c) PROMOTION OF PUBLIC AWARENESS OF IN25 HOME SERVICE EXPENSES ELIGIBLE FOR TAX-FREE


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1 DISTRIBUTION FROM HEALTH SAVINGS ACCOUNTS.—The 

2 Secretary of Health and Human Services, in consultation 

3 with the Secretary of the Treasury, shall carry out a cam4 paign to increase public awareness of the in-home service 

5 expenses that are eligible for tax-free distribution from 

6 health savings accounts. 

Æ 


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