II 
115TH CONGRESS 
2D SESSION 
H. R. 6311 
IN THE SENATE OF THE UNITED STATES 
JULY 26, 2018 
Received 
AN ACT 
To amend the Internal Revenue Code of 1986 and the Pa-
tient Protection and Affordable Care Act to modify the 
definition of qualified health plan for purposes of the 
health insurance premium tax credit and to allow individ-
uals purchasing health insurance in the individual market 
to purchase a lower premium copper plan. 
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Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 
(a) SHORT TITLE.—This Act may be cited as the 
‘‘Increasing Access to Lower Premium Plans and Expand-
ing Health Savings Accounts Act of 2018’’. 
(b) TABLE OF CONTENTS.—The table of contents for 
this Act is as follows: 
Sec. 1. Short title; table of contents. 
Sec. 2. Carryforward of health flexible spending arrangement account balances. 
Sec. 3. Individuals entitled to part A of Medicare by reason of age allowed to 
contribute to health savings accounts. 
Sec. 4. Maximum contribution limit to health savings account increased to 
amount of deductible and out-of-pocket limitation. 
Sec. 5. Allow both spouses to make catch-up contributions to the same health 
savings account. 
Sec. 6. Special rule for certain medical expenses incurred before establishment 
of health savings account. 
Sec. 7. Allowance of bronze and catastrophic plans in connection with health 
savings accounts. 
Sec. 8. Allowing all individuals purchasing health insurance in the individual 
market the option to purchase a lower premium copper plan. 
Sec. 9. Delay of reimposition of annual fee on health insurance providers. 
SEC. 2. CARRYFORWARD OF HEALTH FLEXIBLE SPENDING 
ARRANGEMENT ACCOUNT BALANCES. 
(a) IN GENERAL.—Section 106 of the Internal Rev-
enue Code of 1986 is amended by adding at the end the 
following new subsection: 
‘‘(h) 
CARRYFORWARD
OF
HEALTH
FLEXIBLE 
SPENDING ARRANGEMENT ACCOUNT BALANCES.—A plan 
shall not fail to be treated as a health flexible spending 
arrangement under this section or section 105 merely be-
cause the lesser of— 
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‘‘(1) such arrangement’s account balance (or 
any portion thereof) determined as of the end of any 
plan year, or 
‘‘(2) the product of the dollar limitation in ef-
fect under section 125(i) for such plan year (deter-
mined without regard to paragraph (2) thereof) mul-
tiplied by 3, 
may be carried forward to the succeeding plan year.’’. 
(b) COORDINATION WITH LIMITATION ON SALARY 
REDUCTION CONTRIBUTIONS.— 
(1) IN GENERAL.—Section 125(i) of such Code 
is amended by redesignating paragraph (2) as para-
graph (3) and by inserting after paragraph (1) the 
following new paragraph: 
‘‘(2) COORDINATION WITH CARRYFORWARD OF 
ACCOUNT BALANCES.—The dollar amount otherwise 
in effect under paragraph (1) for any plan year shall 
be reduced (but not below zero) by the excess (if 
any) of— 
‘‘(A) the amount of any account balance 
which is carried forward to such plan year from 
the preceding plan year, over 
‘‘(B) twice the dollar limitation in effect 
under paragraph (1) (determined without re-
gard to this paragraph).’’. 
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(2) 
CONFORMING
AMENDMENTS.—Section 
125(i) of such Code is amended by striking ‘‘taxable 
year’’ each place it appears in paragraphs (1) and 
(3) (as redesignated by paragraph (1) of this sub-
section) and inserting ‘‘plan year’’. 
(c) COORDINATION WITH CAFETERIA PLAN LIMITA-
TION ON DEFERRED COMPENSATION.—Section 125(d)(2) 
of such Code is amended by adding at the end the fol-
lowing new subparagraph: 
‘‘(E) EXCEPTION FOR HEALTH FLEXIBLE 
SPENDING ARRANGEMENTS.—Subparagraph (A) 
shall not apply to a plan to the extent of 
amounts in a health flexible spending arrange-
ment which may be carried forward as de-
scribed in section 106(h).’’. 
(d) EFFECTIVE DATE.—The amendments made by 
this section shall apply to plan years beginning after De-
cember 31, 2018. 
SEC. 3. INDIVIDUALS ENTITLED TO PART A OF MEDICARE 
BY REASON OF AGE ALLOWED TO CON-
TRIBUTE TO HEALTH SAVINGS ACCOUNTS. 
(a) IN GENERAL.—Section 223(c)(1)(B) of the Inter-
nal Revenue Code of 1986 is amended by striking ‘‘and’’ 
at the end of clause (ii), by striking the period at the end 
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of clause (iii) and inserting ‘‘, and’’, and by adding at the 
end the following new clause: 
‘‘(iv) entitlement to hospital insurance 
benefits under part A of title XVIII of the 
Social Security Act by reason of section 
226(a) of such Act.’’. 
(b) CONFORMING AMENDMENT.—Section 223(b)(7) 
of such Code is amended by inserting ‘‘(other than an enti-
tlement to benefits described in subsection (c)(1)(B)(v))’’ 
after ‘‘Social Security Act’’. 
(c) EFFECTIVE DATE.—The amendments made by 
this section shall apply to months beginning after Decem-
ber 31, 2018, in taxable years ending after such date. 
SEC. 4. MAXIMUM CONTRIBUTION LIMIT TO HEALTH SAV-
INGS ACCOUNT INCREASED TO AMOUNT OF 
DEDUCTIBLE AND OUT-OF-POCKET LIMITA-
TION. 
(a) SELF-ONLY COVERAGE.—Section 223(b)(2)(A) 
of the Internal Revenue Code of 1986 is amended by strik-
ing ‘‘$2,250’’ and inserting ‘‘the amount in effect under 
subsection (c)(2)(A)(ii)(I)’’. 
(b) FAMILY COVERAGE.—Section 223(b)(2)(B) of 
such Code is amended by striking ‘‘$4,500’’ and inserting 
‘‘the amount in effect under subsection (c)(2)(A)(ii)(II)’’. 
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(c) CONFORMING AMENDMENTS.—Section 223(g)(1) 
of such Code is amended— 
(1) by striking ‘‘subsections (b)(2) and’’ both 
places it appears and inserting ‘‘subsection’’, and 
(2) in subparagraph (B), by striking ‘‘deter-
mined by’’ and all that follows through ‘‘ ‘calendar 
year 2003’.’’ and inserting ‘‘determined by sub-
stituting ‘calendar year 2003’ for ‘calendar year 
2016’ in subparagraph (A)(ii) thereof.’’. 
(d) EFFECTIVE DATE.—The amendments made by 
this section shall apply to taxable years beginning after 
December 31, 2018. 
SEC. 5. ALLOW BOTH SPOUSES TO MAKE CATCH-UP CON-
TRIBUTIONS TO THE SAME HEALTH SAVINGS 
ACCOUNT. 
(a) IN GENERAL.—Section 223(b)(5) of the Internal 
Revenue Code of 1986 is amended to read as follows: 
‘‘(5) SPECIAL RULE FOR MARRIED INDIVIDUALS 
WITH FAMILY COVERAGE.— 
‘‘(A) IN GENERAL.—In the case of individ-
uals who are married to each other, if both 
spouses are eligible individuals and either 
spouse has family coverage under a high de-
ductible health plan as of the first day of any 
month— 
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‘‘(i) the limitation under paragraph 
(1) shall be applied by not taking into ac-
count any other high deductible health 
plan coverage of either spouse (and if such 
spouses both have family coverage under 
separate high deductible health plans, only 
one such coverage shall be taken into ac-
count), 
‘‘(ii) such limitation (after application 
of clause (i)) shall be reduced by the ag-
gregate amount paid to Archer MSAs of 
such spouses for the taxable year, and 
‘‘(iii) such limitation (after application 
of clauses (i) and (ii)) shall be divided 
equally between such spouses unless they 
agree on a different division. 
‘‘(B) TREATMENT
OF
ADDITIONAL
CON-
TRIBUTION AMOUNTS.—If both spouses referred 
to in subparagraph (A) have attained age 55 
before the close of the taxable year, the limita-
tion referred to in subparagraph (A)(iii) which 
is subject to division between the spouses shall 
include the additional contribution amounts de-
termined under paragraph (3) for both spouses. 
In any other case, any additional contribution 
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amount determined under paragraph (3) shall 
not be taken into account under subparagraph 
(A)(iii) and shall not be subject to division be-
tween the spouses.’’. 
(b) EFFECTIVE DATE.—The amendments made by 
this section shall apply to taxable years beginning after 
December 31, 2018. 
SEC. 6. SPECIAL RULE FOR CERTAIN MEDICAL EXPENSES 
INCURRED 
BEFORE 
ESTABLISHMENT 
OF 
HEALTH SAVINGS ACCOUNT. 
(a) IN GENERAL.—Section 223(d)(2) of the Internal 
Revenue Code of 1986 is amended by adding at the end 
the following new subparagraph: 
‘‘(D) TREATMENT OF CERTAIN MEDICAL 
EXPENSES INCURRED BEFORE ESTABLISHMENT 
OF ACCOUNT.—If a health savings account is 
established during the 60-day period beginning 
on the date that coverage of the account bene-
ficiary under a high deductible health plan be-
gins, then, solely for purposes of determining 
whether an amount paid is used for a qualified 
medical expense, such account shall be treated 
as having been established on the date that 
such coverage begins.’’. 
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(b) EFFECTIVE DATE.—The amendment made by 
this section shall apply with respect to coverage beginning 
after December 31, 2018. 
SEC. 7. ALLOWANCE OF BRONZE AND CATASTROPHIC 
PLANS IN CONNECTION WITH HEALTH SAV-
INGS ACCOUNTS. 
(a) IN GENERAL.—Section 223(c)(2) of the Internal 
Revenue Code of 1986 is amended by adding at the end 
the following new subparagraph: 
‘‘(E) BRONZE AND CATASTROPHIC PLANS 
TREATED
AS
HIGH
DEDUCTIBLE
HEALTH 
PLANS.— 
‘‘(i) IN
GENERAL.—The term ‘high 
deductible health plan’ shall include any 
plan described in subsection (d)(1)(A) or 
(e) of section 1302 of the Patient Protec-
tion and Affordable Care Act. 
‘‘(ii) CERTAIN RULES NOT APPLICA-
BLE.—Subparagraphs (C) and (D) shall 
not apply with respect to any plan de-
scribed in clause (i).’’. 
(b) EFFECTIVE DATE.—The amendment made by 
this section shall apply to months beginning after Decem-
ber 31, 2018, in taxable years ending after such date. 
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SEC. 8. ALLOWING ALL INDIVIDUALS PURCHASING HEALTH 
INSURANCE IN THE INDIVIDUAL MARKET 
THE OPTION TO PURCHASE A LOWER PRE-
MIUM COPPER PLAN. 
(a) IN GENERAL.—Section 1302(e) of the Patient 
Protection and Affordable Care Act (42 U.S.C. 18022(e)) 
is amended— 
(1) in paragraph (1)— 
(A) by redesignating clauses (i) and (ii) of 
subparagraph (B) as subparagraphs (A) and 
(B), respectively, and adjusting the margins ac-
cordingly; 
(B) by striking ‘‘plan year if—’’ and all 
that follows through ‘‘the plan provides—’’ and 
inserting ‘‘plan year if the plan provides—’’; 
and 
(C) in subparagraph (A), as redesignated 
by paragraph (1), by striking ‘‘clause (ii)’’ and 
inserting ‘‘subparagraph (B)’’; 
(2) by striking paragraph (2); and 
(3) by redesignating paragraph (3) as para-
graph (2). 
(b) RISK POOLS.—Section 1312(c)(1) of the Patient 
Protection 
and 
Affordable 
Care 
Act 
(42 
U.S.C. 
18032(c)(1)) is amended by inserting ‘‘and enrollees in 
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catastrophic plans described in section 1302(e)’’ after 
‘‘Exchange’’. 
(c) 
CONFORMING
AMENDMENT.—Section 
1312(d)(3)(C) of the Patient Protection and Affordable 
Care Act (42 U.S.C. 18032(d)(3)(C)) is amended by strik-
ing ‘‘, except that in the case of a catastrophic plan de-
scribed in section 1302(e), a qualified individual may en-
roll in the plan only if the individual is eligible to enroll 
in the plan under section 1302(e)(2)’’. 
(d) EFFECTIVE DATE.—The amendments made by 
this section shall apply to plan years beginning after De-
cember 31, 2018. 
SEC. 9. DELAY OF REIMPOSITION OF ANNUAL FEE ON 
HEALTH INSURANCE PROVIDERS. 
(a) IN GENERAL.—Section 9010(j)(3) of the Patient 
Protection and Affordable Care Act is amended by strik-
ing ‘‘December 31, 2019’’ and inserting ‘‘December 31, 
2021’’. 
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(b) EFFECTIVE DATE.—The amendment made by 
this section shall apply to calendar years beginning after 
December 31, 2019. 
Passed the House of Representatives July 25, 2018. 
Attest: 
KAREN L. HAAS, 
Clerk. 
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