I 

113TH CONGRESS 

1ST SESSION H. R. 1342 

To repeal provisions of the Patient Protection and Affordable Care Act 

relating to health savings accounts, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

MARCH 21, 2013 

Mr. FLEMING introduced the following bill; which was referred to the Committee on Ways and Means, and in addition to the Committee on Energy 

and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned 

A BILL 

To repeal provisions of the Patient Protection and Affordable 

Care Act relating 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, ETC. 

4 (a) SHORT TITLE.—This Act may be cited as the 

5 ‘‘Helping Save Americans’ Health Care Choices Act of 

6 2013’’. 

7 (b) TABLE OF SECTIONS.—The table of sections for 

8 this Act is as follows: 


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Sec. 1. Short title, etc. 

Sec. 2. Repeal of additional tax from distributions from HSAs and MSAs. 

Sec. 3. Repeal of limitation on deductions making non-prescription drugs nonqualifying distributions from tax-preferred accounts. 

Sec. 4. Treatment of high deductible health plans as qualified health plan under 

the Patient Protection and Affordable Care Act. 

Sec. 5. Repeal of limitation on health flexible spending arrangements under cafeteria plans. 

Sec. 6. Saver’s credit for contributions to health savings accounts. 

Sec. 7. HSA funds for premiums for high deductible health plans. 

Sec. 8. Requiring greater coordination between high deductible health plan administrators and HSA account administrators so that enrollees 

can enroll in both at the same time. 

Sec. 9. Special rule for certain medical expenses incurred before establishment 

of account. 

Sec. 10. Provisions relating to medicare. 

Sec. 11. Individuals eligible for veterans benefits for a service-connected disability. 

Sec. 12. Increase the maximum contribution limit to an HSA to match deductible and out-of-pocket expense limitation. 

Sec. 13. FSA funds may be used for long-term care insurance premiums. 

Sec. 14. Individuals eligible for TRICARE. 

Sec. 15. Certain physician fees to be treated as medical care. 

Sec. 16. Allow both spouses to make catch-up contributions to the same HSA 

account. 

Sec. 17. High deductible health plans renamed as HSA qualified health plans. 

1 SEC. 2. REPEAL OF ADDITIONAL TAX FROM DISTRIBUTIONS 

2 FROM HSAS AND MSAS. 

3 Section 9004 of the Patient Protection and Afford4 able Care Act is hereby repealed, and effective as of the 

5 date of the enactment of such Act the provisions of the 

6 Internal Revenue Code of 1986 amended by such section 

7 are amended to read as such provisions would read if such 

8 section had never been enacted. 


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1 SEC. 3. REPEAL OF LIMITATION ON DEDUCTIONS MAKING 

2 NON-PRESCRIPTION DRUGS NON-QUALI3 FYING DISTRIBUTIONS FROM TAX-PRE4 FERRED ACCOUNTS. 

5 Section 9003 of the Patient Protection and Afford6 able Care Act is hereby repealed, and effective as of the 

7 date of the enactment of such Act the provisions of the 

8 Internal Revenue Code of 1986 amended by such section 

9 are amended to read as such provisions would read if such 

10 section had never been enacted. 

11 SEC. 4. TREATMENT OF HIGH DEDUCTIBLE HEALTH PLANS 

12 AS QUALIFIED HEALTH PLAN UNDER THE PA13 TIENT PROTECTION AND AFFORDABLE CARE 

14 ACT. 

15 Subparagraph (B) of section 1301(a)(1) of the Pa16 tient Protection and Affordable Care Act is amended by 

17 inserting ‘‘or meets the requirements for a high deductible 

18 health plan under section 223(c)(2) of the Internal Rev19 enue Code of 1986’’ after ‘‘section 1302(a)’’. 

20 SEC. 5. REPEAL OF LIMITATION ON HEALTH FLEXIBLE 

21 SPENDING ARRANGEMENTS UNDER CAFE22 TERIA PLANS. 

23 Sections 9005 and 10902 of the Patient Protection 

24 and Affordable Care Act are hereby repealed, and effective 

25 as of the date of the enactment of such Act the provisions 

26 of the Internal Revenue Code of 1986 amended by such 


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1 sections are amended to read as such provisions would 

2 read if such sections had never been enacted. 

3 SEC. 6. SAVER’S CREDIT FOR CONTRIBUTIONS TO HEALTH 

4 SAVINGS ACCOUNTS. 

5 (a) ALLOWANCE OF CREDIT.—Subsection (a) of sec6 tion 25B of the Internal Revenue Code of 1986 is amend7 ed by inserting ‘‘aggregate qualified HSA contributions 

8 and’’ after ‘‘so much of the’’. 

9 (b) QUALIFIED HSA CONTRIBUTIONS.—Subsection 

10 (d) of section 25B of such Code is amended by redesig11 nating paragraph (2) as paragraph (3) and by inserting 

12 after paragraph (1) the following new paragraph: 

13 ‘‘(2) QUALIFIED HSA CONTRIBUTIONS.—The 

14 term ‘qualified HSA contribution’ means, with re15 spect to any taxable year, a contribution of the eligi16 ble individual to a health savings account (as defined 

17 in section 223(d)(1)) for which a deduction is allow18 able under section 223(a) for such taxable year.’’. 

19 (c) CONFORMING AMENDMENT.—The first sentence 

20 of section 25B(d)(3)(A) of such Code (as redesignated by 

21 subsection (b)) is amended to read as follows: ‘‘The aggre22 gate qualified retirement savings contributions determined 

23 under paragraph (1) and qualified HSA contributions de24 termined under paragraph (2) shall be reduced (but not 

25 below zero) by the aggregate distributions received by the 


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1 individual during the testing period from any entity of a 

2 type to which contributions under paragraph (1) or para3 graph (2) (as the case may be) may be made.’’. 

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

5 this section shall apply to contributions made after De6 cember 31, 2013. 

7 SEC. 7. HSA FUNDS FOR PREMIUMS FOR HIGH DEDUCT8 IBLE HEALTH PLANS. 

9 (a) IN GENERAL.—Subparagraph (C) of section 

10 223(d)(2) of the Internal Revenue Code of 1986 is amend11 ed by striking ‘‘or’’ at the end of clause (iii), by striking 

12 the period at the end of clause (iv) and inserting ‘‘, or’’, 

13 and by adding at the end the following: 

14 ‘‘(v) a high deductible health plan if— 

15 ‘‘(I) such plan is not offered in 

16 connection with a group health plan, 

17 and 

18 ‘‘(II) no portion of any premium 

19 (within the meaning of applicable pre20 mium under section 4980B(f)(4)) for 

21 such plan is excludable from gross in22 come under section 106.’’. 

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

24 subsection (a) shall apply to premiums for a high deductVerDate Mar 15 2010 21:43 Mar 28, 2013 Jkt 029200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H1342.IH H1342

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1 ible health plan for periods beginning after December 31, 

2 2013. 

3 SEC. 8. REQUIRING GREATER COORDINATION BETWEEN 

4 HIGH DEDUCTIBLE HEALTH PLAN ADMINIS5 TRATORS AND HSA ACCOUNT ADMINISTRA6 TORS SO THAT ENROLLEES CAN ENROLL IN 

7 BOTH AT THE SAME TIME. 

8 The Secretary of the Treasury, through the issuance 

9 of regulations or other guidance, shall encourage adminis10 trators of health plans and trustees of health savings ac11 counts to provide for simultaneous enrollment in high de12 ductible health plans and setup of health savings accounts. 

13 SEC. 9. SPECIAL RULE FOR CERTAIN MEDICAL EXPENSES 

14 INCURRED BEFORE ESTABLISHMENT OF AC15 COUNT. 

16 (a) IN GENERAL.—Subsection (d) of section 223 of 

17 the Internal Revenue Code of 1986 is amended by redesig18 nating paragraph (4) as paragraph (5) and by inserting 

19 after paragraph (3) the following new paragraph: 

20 ‘‘(4) TREATMENT OF ACCOUNT ESTABLISHED

21 BEFORE TAX RETURN DUE FOR TAX YEAR.—For 

22 purposes of this section, if, before the time pre23 scribed by law for filing the return of tax for a tax24 able year (not including extensions thereof), a tax25 payer— 


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1 ‘‘(A) establishes a health savings account, 

2 ‘‘(B) makes contributions to a health sav3 ings account on account of such taxable year, or 

4 ‘‘(C) makes payments or distributions from 

5 a health savings account for such taxable year, 

6 the health savings account shall be deemed to be es7 tablished on the last day of such taxable year and 

8 such contributions and distributions shall be deemed 

9 to have been made on account of such taxable 

10 year.’’. 

11 (b) CONFORMING AMENDMENT.—Paragraph (5) of 

12 section 223(d) of such Code, as redesignated by subsection 

13 (a), is amended by striking subparagraph (B) and redesig14 nating subparagraphs (C) through (E) as subparagraphs 

15 (B) through (D), respectively. 

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

17 this section shall apply with respect to health savings ac18 counts established, and contributions to and distributions 

19 from health savings accounts after, the date of the enact20 ment of this Act. 

21 SEC. 10. PROVISIONS RELATING TO MEDICARE. 

22 (a) INDIVIDUALS OVER AGE 65 ONLY ENROLLED IN

23 MEDICARE PART A.—Section 223(b)(7) of the Internal 

24 Revenue Code of 1986 (relating to contribution limitation 

25 on Medicare eligible individuals) is amended by adding at 


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1 the end the following new sentence: ‘‘This paragraph shall 

2 not apply to any individual during any period the individ3 ual’s only entitlement to such benefits is an entitlement 

4 to hospital insurance benefits under part A of title XVIII 

5 of such Act pursuant to an enrollment for such hospital 

6 insurance benefits under section 226(a)(1) of such Act.’’. 

7 (b) MEDICARE BENEFICIARIES PARTICIPATING IN

8 MEDICARE ADVANTAGE MSA MAY CONTRIBUTE THEIR

9 OWN MONEY TO THEIR MSA.—Subsection (b) of section 

10 138 of such Code is amended by striking paragraph (2) 

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

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

14 this section shall apply to taxable years beginning after 

15 the date of the enactment of this Act. 

16 SEC. 11. INDIVIDUALS ELIGIBLE FOR VETERANS BENEFITS 

17 FOR A SERVICE-CONNECTED DISABILITY. 

18 (a) IN GENERAL.—Section 223(c)(1) of the Internal 

19 Revenue Code of 1986 (defining eligible individual) is 

20 amended by adding at the end the following new subpara21 graph: 

22 ‘‘(C) SPECIAL RULE FOR INDIVIDUALS ELI23 GIBLE FOR CERTAIN VETERANS BENEFITS.— 

24 For purposes of subparagraph (A)(ii), an indi25 vidual shall not be treated as covered under a 


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1 health plan described in such subparagraph 

2 merely because the individual receives periodic 

3 hospital care or medical services for a service4 connected disability under any law administered 

5 by the Secretary of Veterans Affairs but only if 

6 the individual is not eligible to receive such care 

7 or services for any condition other than a serv8 ice-connected disability.’’. 

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

10 this section shall apply to taxable years beginning after 

11 the date of the enactment of this Act. 

12 SEC. 12. INCREASE THE MAXIMUM CONTRIBUTION LIMIT 

13 TO AN HSA TO MATCH DEDUCTIBLE AND 

14 OUT-OF-POCKET EXPENSE LIMITATION. 

15 (a) SELF-ONLY COVERAGE.—Subparagraph (A) of 

16 section 223(b)(2) of the Internal Revenue Code of 1986 

17 is amended by striking ‘‘$2,250’’ and inserting ‘‘the 

18 amount in effect under subsection (c)(2)(A)(ii)(I)’’. 

19 (b) FAMILY COVERAGE.—Subparagraph (B) of sec20 tion 223(b)(2) of such Code is amended by striking 

21 ‘‘$4,500’’ and inserting ‘‘the amount in effect under sub22 section (c)(2)(A)(ii)(II)’’. 

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

24 this section shall apply to taxable years beginning after 

25 the date of the enactment of this Act. 


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1 SEC. 13. FSA FUNDS MAY BE USED FOR LONG-TERM CARE 

2 INSURANCE PREMIUMS. 

3 (a) IN GENERAL.—Subsection (c) of section 106 of 

4 the Internal Revenue Code of 1986 is amended by redesig5 nating paragraph (2) as paragraph (3) and by amending 

6 so much of such subsection as precedes such paragraph 

7 (3) to read as follows: 

8 ‘‘(c) LONG-TERM CARE BENEFITS PROVIDED

9 THROUGH FLEXIBLE SPENDING ARRANGEMENTS.— 

10 ‘‘(1) IN GENERAL.—Effective on and after Jan11 uary 1, 2013, gross income of an employee shall not 

12 include employer-provided coverage for qualified 

13 long-term care services (as defined in section 

14 7702B(c)) to the extent that such coverage is pro15 vided through a flexible spending or similar arrange16 ment. 

17 ‘‘(2) PREMIUMS FOR LONG-TERM CARE.—Quali18 fied medical expenses for which reimbursement may 

19 be made by distributions from a flexible spending ar20 rangement shall include amounts paid for long-term 

21 care coverage.’’. 

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

23 this section shall apply to taxable years beginning after 

24 December 31, 2013. 


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1 SEC. 14. INDIVIDUALS ELIGIBLE FOR TRICARE. 

2 (a) IN GENERAL.—Section 223(c)(1) of the Internal 

3 Revenue Code of 1986 (defining eligible individual), as 

4 amended by section 11, is amended by adding at the end 

5 the following new subparagraph: 

6 ‘‘(D) SPECIAL RULE FOR INDIVIDUALS EL7 IGIBLE FOR ASSISTANCE UNDER TRICARE.—For 

8 purposes of subparagraph (A)(ii), an individual 

9 shall not be treated as covered under a health 

10 plan described in such subparagraph merely be11 cause the individual is eligible to receive hos12 pital care, medical services, or prescription 

13 drugs under TRICARE Extra or TRICARE 

14 Standard and such individual is not enrolled in 

15 TRICARE Prime.’’. 

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

17 this section shall apply to taxable years beginning after 

18 the date of the enactment of this Act. 

19 SEC. 15. CERTAIN PHYSICIAN FEES TO BE TREATED AS 

20 MEDICAL CARE. 

21 (a) IN GENERAL.—Subsection (d) of section 213 of 

22 the Internal Revenue Code of 1986 is amended by adding 

23 at the end the following new paragraph: 

24 ‘‘(12) PRE-PAID PHYSICIAN FEES.—The term 

25 ‘medical care’ shall include amounts paid by patients 


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1 to their primary physician in advance for the right 

2 to receive medical services on an as-needed basis.’’. 

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

4 this section shall apply to taxable years beginning after 

5 the date of the enactment of this Act. 

6 SEC. 16. ALLOW BOTH SPOUSES TO MAKE CATCH-UP CON7 TRIBUTIONS TO THE SAME HSA ACCOUNT. 

8 (a) IN GENERAL.—Paragraph (3) of section 223(b) 

9 of the Internal Revenue Code of 1986 is amended by add10 ing at the end the following new subparagraph: 

11 ‘‘(C) SPECIAL RULE WHERE BOTH

12 SPOUSES ARE ELIGIBLE INDIVIDUALS WITH 1

13 ACCOUNT.—If— 

14 ‘‘(i) an individual and the individual’s 

15 spouse have both attained age 55 before 

16 the close of the taxable year, and 

17 ‘‘(ii) the spouse is not an account ben18 eficiary of a health savings account as of 

19 the close of such year, 

20 the additional contribution amount shall be 200 

21 percent of the amount otherwise determined 

22 under subparagraph (B).’’. 

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

24 this section shall apply to taxable years beginning after 

25 the date of the enactment of this Act. 


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1 SEC. 17. HIGH DEDUCTIBLE HEALTH PLANS RENAMED AS 

2 HSA QUALIFIED HEALTH PLANS. 

3 (a) IN GENERAL.—The following sections of the In4 ternal Revenue Code of 1986 are each amended by strik5 ing ‘‘high deductible health plan’’ each place it appears 

6 and inserting ‘‘HSA qualified health plan’’: 

7 (1) Section 26(b)(2)(S). 

8 (2) Paragraphs (3) and (5)(B)(ii) of section 

9 106(e). 

10 (3) Section 223. 

11 (4) Section 408(d)(9). 

12 (b) SPECIAL RULES.—The amendments made by this 

13 section, the matter being inserted shall bear the same 

14 case, number, font, and font size as the matter being re15 placed. 

Æ 


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