I 

118TH CONGRESS 

1ST SESSION H. R. 1795 

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 

MARCH 24, 2023 

Mr. SMITH of Nebraska (for himself, Ms. PORTER, Mr. BACON, Mr. TONKO, 

Mr. FLOOD, Ms. LOIS FRANKEL of Florida, Mr. FITZPATRICK, Mr. 

NEGUSE, Mr. BALDERSON, and Mr. MEUSER) 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’’, and 

9 (2) by adding at the end the following new sub10 paragraph: 

11 ‘‘(E) SPECIFIED MEDICAL CARE.—For 

12 purposes of this paragraph— 

13 ‘‘(i) IN GENERAL.—The term ‘speci14 fied medical care’ means medical care (as 

15 defined in section 213(d)) and qualified 

16 home care. 

17 ‘‘(ii) QUALIFIED HOME CARE.—The 

18 term ‘qualified home care’ means a con19 tract to provide 3 or more of the following 

20 services in the residence of the service re21 cipient: 

22 ‘‘(I) Assistance with eating. 

23 ‘‘(II) Assistance with toileting. 

24 ‘‘(III) Assistance with transfer25 ring. 

26 ‘‘(IV) Assistance with bathing. 


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1 ‘‘(V) Assistance with dressing. 

2 ‘‘(VI) Assistance with continence. 

3 ‘‘(VII) Medication adherence. 

4 Such term shall not include any contract 

5 unless the services provided pursuant to 

6 such contract are provided by a service 

7 provider which is licensed by the State to 

8 provide such services or such services are 

9 otherwise provided in a manner that is 

10 consistent with State requirements. 

11 ‘‘(iii) RELATED PARTIES.—The term 

12 ‘qualified home care’ shall not include any 

13 contract which is, directly or indirectly, be14 tween a service provider and a service re15 cipient who are related within the meaning 

16 of section 267(b) or 707(b).’’. 

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

18 this section shall apply to amounts paid with respect to 

19 taxable years beginning after the date of the enactment 

20 of this Act. 

21 (c) PROMOTION OF PUBLIC AWARENESS OF IN22 HOME SERVICE EXPENSES ELIGIBLE FOR TAX-FREE

23 DISTRIBUTION FROM HEALTH SAVINGS ACCOUNTS.—The 

24 Secretary of Health and Human Services, in consultation 

25 with the Secretary of the Treasury, shall carry out a camVerDate Sep 11 2014 18:04 Apr 08, 2023 Jkt 039200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H1795.IH H1795

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1 paign to increase public awareness of the in-home service 

2 expenses that are eligible for tax-free distribution from 

3 health savings accounts. 

Æ 


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