I 
118TH CONGRESS 
1ST SESSION H. R. 4803 
To amend the Internal Revenue Code of 1986 to expand and improve health 
savings accounts, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
JULY 20, 2023 
Mr. ROY (for himself, Mr. BISHOP of North Carolina, Mr. MEUSER, Mr. NOR-
MAN, Mr. BIGGS, Mrs. SPARTZ, Mr. GAETZ, Mr. GOSAR, Mr. ROUZER, 
Ms. HAGEMAN, Mr. GOOD of Virginia, Mr. TIFFANY, Ms. MACE, Mr. 
WILLIAMS of Texas, and Mr. BABIN) 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 expand 
and improve health savings accounts, and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Personalized Care Act 
of 2023’’. 
SEC. 2. HEALTH SAVINGS ACCOUNT ELIGIBILITY. 
(a) IN GENERAL.—Paragraph (1) of section 223(c) 
of the Internal Revenue Code of 1986 is amended to read 
as follows: 
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‘‘(1) ELIGIBLE INDIVIDUAL.—The term ‘eligible 
individual’ means, with respect to any month, any 
individual if such individual is— 
‘‘(A) covered under— 
‘‘(i) a group or individual health plan, 
‘‘(ii) health insurance coverage, in-
cluding a short term limited duration plan 
or medical indemnity plan, or 
‘‘(iii) a government plan, including 
coverage under the Medicare program 
under part A or part B of title XVIII of 
the Social Security Act, the Medicaid pro-
gram under title XIX of such Act, the 
CHIP program under title XXI of such 
Act or a qualified CHIP look-alike pro-
gram (as defined in section 2107(g) of 
such Act), medical coverage under chapter 
55 of title 10, United States Code (includ-
ing coverage under the TRICARE pro-
gram), a health care program under chap-
ter 17 or 18 of title 38, United States 
Code, as determined by the Secretary of 
Veterans Affairs in coordination with the 
Secretary of Health and Human Services 
and the Secretary, a medical care program 
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(C) by adding at the end the following new 
clause: 
‘‘(v) a health plan or health insurance 
coverage 
described 
in 
subsection 
(c)(1)(A).’’. 
(b) EFFECTIVE DATE.—The amendments made by 
this section shall apply to taxable years beginning after 
December 31, 2023. 
SEC. 5. TREATMENT OF MEDICAL CARE SERVICE ARRANGE-
MENTS. 
(a) INCLUSION AS MEDICAL EXPENSES.—Paragraph 
(2) of section 223(d) of the Internal Revenue Code of 
1986, as amended by section 4, is further amended by 
adding at the end the following new subparagraph: 
‘‘(D) INCLUSION OF MEDICAL CARE SERV-
ICE ARRANGEMENTS.—The term ‘qualified med-
ical expenses’ shall include— 
‘‘(i) periodic fees paid to a physician 
for a defined set of medical services or for 
the right to receive medical services on an 
as-needed basis, and 
‘‘(ii) amounts prepaid for medical 
services designed to screen for, diagnose, 
cure, mitigate, treat, or prevent disease 
and promote wellness.’’. 
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(b) ARRANGEMENT
NOT
TO
BE
TREATED
AS 
HEALTH INSURANCE.—Subsection (c) of section 223 of 
the Internal Revenue Code of 1986, as amended by section 
2(b), is further amended by adding at the end the fol-
lowing new paragraph: 
‘‘(4) TREATMENT OF MEDICAL CARE SERVICE 
ARRANGEMENTS.—An arrangement under which an 
individual is provided medical services in exchange 
for a fixed periodic fee or payment for such services 
shall not be treated as a health plan, insurance, or 
arrangement described in paragraph (1).’’. 
(c) EFFECTIVE DATE.—The amendments made by 
this section shall apply to taxable years beginning after 
December 31, 2023. 
SEC. 6. PERIODIC PROVIDER FEES TREATED AS MEDICAL 
CARE. 
(a) IN GENERAL.—Section 213(d) of the Internal 
Revenue Code of 1986 is amended by adding at the end 
the following new paragraph: 
‘‘(12) PERIODIC
PROVIDER
FEES.—Periodic 
fees paid for a defined set of medical services pro-
vided on an as-needed basis shall be treated as 
amounts paid for medical care.’’. 
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(b) EFFECTIVE DATE.—The amendment made by 
this section shall apply to taxable years beginning after 
December 31, 2023. 
SEC. 7. RESTORING LOWER PENALTY FOR NONQUALIFIED 
DISTRIBUTIONS. 
(a) IN GENERAL.—Section 223(e)(4)(A) of the Inter-
nal Revenue Code of 1986 is amended by striking ‘‘20 per-
cent’’ and inserting ‘‘10 percent’’. 
(b) EFFECTIVE DATE.—The amendments made by 
this section shall apply to distributions made in taxable 
years beginning after December 31, 2023. 
SEC. 8. TREATMENT OF HEALTH CARE SHARING MIN-
ISTRIES. 
(a) INCLUSION AS MEDICAL EXPENSES.—Paragraph 
(2) of section 223(d) of the Internal Revenue Code of 
1986, as amended by sections 4 and 5, is further amended 
by adding at the end the following new subparagraph: 
‘‘(E) INCLUSION OF HEALTH CARE SHAR-
ING MINISTRIES.—The term ‘qualified medical 
expenses’ shall include amounts paid by a mem-
ber of a health care sharing ministry (as de-
fined in section 5000A(d)(2)(B)(ii) without re-
gard to subclause (IV) thereof) for— 
‘‘(i) the sharing of medical expenses 
among members, and 
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‘‘(ii) administrative fees of the min-
istry.’’. 
(b) HEALTH CARE SHARING MINISTRY NOT TO BE 
TREATED AS HEALTH INSURANCE.—Subsection (c) of 
section 223 of the Internal Revenue Code of 1986, as 
amended by sections 2 and 5, is further amended by add-
ing at the end the following new paragraph: 
‘‘(5) TREATMENT OF HEALTH CARE SHARING 
MINISTRIES.—A health care sharing ministry (as de-
fined in section 5000A(d)(2)(B)(ii) without regard 
to subclause (IV) thereof) shall not be treated as a 
health plan or insurance for purposes of this title.’’. 
(c) EFFECTIVE DATE.—The amendments made by 
this section shall apply to taxable years beginning after 
December 31, 2023. 
SEC. 9. HEALTH CARE SHARING MINISTRY FEES TREATED 
AS MEDICAL CARE. 
(a) IN GENERAL.—Section 213(d) of the Internal 
Revenue Code of 1986, as amended by section 6, is further 
amended by adding at the end the following new para-
graph: 
‘‘(13) HEALTH CARE SHARING MINISTRIES.— 
Amounts paid for membership in a health care shar-
ing 
ministry 
(as 
defined 
in 
section 
5000A(d)(2)(B)(ii) without regard to subclause (IV) 
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thereof) shall be treated as amounts paid for medical 
care.’’. 
(b) EFFECTIVE DATE.—The amendment made by 
this section shall apply to taxable years beginning after 
December 31, 2023. 
Æ 
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