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 Com-
mittee on Ways and Means, and in addition to the Committee on Energy 
and Commerce, for a period to be subsequently determined by the Speak-
er, in each case for consideration of such provisions as fall within the ju-
risdiction 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. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE, ETC. 
(a) SHORT TITLE.—This Act may be cited as the 
‘‘Helping Save Americans’ Health Care Choices Act of 
2013’’. 
(b) TABLE OF SECTIONS.—The table of sections for 
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 non- 
qualifying 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 caf-
eteria 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 ad-
ministrators 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 dis-
ability. 
Sec. 12. Increase the maximum contribution limit to an HSA to match deduct-
ible 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. 
SEC. 2. REPEAL OF ADDITIONAL TAX FROM DISTRIBUTIONS 
FROM HSAS AND MSAS. 
Section 9004 of the Patient Protection and Afford-
able Care Act is hereby repealed, and effective as of the 
date of the enactment of such Act the provisions of the 
Internal Revenue Code of 1986 amended by such section 
are amended to read as such provisions would read if such 
section had never been enacted. 
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SEC. 3. REPEAL OF LIMITATION ON DEDUCTIONS MAKING 
NON-PRESCRIPTION 
DRUGS 
NON-QUALI-
FYING 
DISTRIBUTIONS 
FROM 
TAX-PRE-
FERRED ACCOUNTS. 
Section 9003 of the Patient Protection and Afford-
able Care Act is hereby repealed, and effective as of the 
date of the enactment of such Act the provisions of the 
Internal Revenue Code of 1986 amended by such section 
are amended to read as such provisions would read if such 
section had never been enacted. 
SEC. 4. TREATMENT OF HIGH DEDUCTIBLE HEALTH PLANS 
AS QUALIFIED HEALTH PLAN UNDER THE PA-
TIENT PROTECTION AND AFFORDABLE CARE 
ACT. 
Subparagraph (B) of section 1301(a)(1) of the Pa-
tient Protection and Affordable Care Act is amended by 
inserting ‘‘or meets the requirements for a high deductible 
health plan under section 223(c)(2) of the Internal Rev-
enue Code of 1986’’ after ‘‘section 1302(a)’’. 
SEC. 5. REPEAL OF LIMITATION ON HEALTH FLEXIBLE 
SPENDING ARRANGEMENTS UNDER CAFE-
TERIA PLANS. 
Sections 9005 and 10902 of the Patient Protection 
and Affordable Care Act are hereby repealed, and effective 
as of the date of the enactment of such Act the provisions 
of the Internal Revenue Code of 1986 amended by such 
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sections are amended to read as such provisions would 
read if such sections had never been enacted. 
SEC. 6. SAVER’S CREDIT FOR CONTRIBUTIONS TO HEALTH 
SAVINGS ACCOUNTS. 
(a) ALLOWANCE OF CREDIT.—Subsection (a) of sec-
tion 25B of the Internal Revenue Code of 1986 is amend-
ed by inserting ‘‘aggregate qualified HSA contributions 
and’’ after ‘‘so much of the’’. 
(b) QUALIFIED HSA CONTRIBUTIONS.—Subsection 
(d) of section 25B of such Code is amended by redesig-
nating paragraph (2) as paragraph (3) and by inserting 
after paragraph (1) the following new paragraph: 
‘‘(2) QUALIFIED
HSA
CONTRIBUTIONS.—The 
term ‘qualified HSA contribution’ means, with re-
spect to any taxable year, a contribution of the eligi-
ble individual to a health savings account (as defined 
in section 223(d)(1)) for which a deduction is allow-
able under section 223(a) for such taxable year.’’. 
(c) CONFORMING AMENDMENT.—The first sentence 
of section 25B(d)(3)(A) of such Code (as redesignated by 
subsection (b)) is amended to read as follows: ‘‘The aggre-
gate qualified retirement savings contributions determined 
under paragraph (1) and qualified HSA contributions de-
termined under paragraph (2) shall be reduced (but not 
below zero) by the aggregate distributions received by the 
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individual during the testing period from any entity of a 
type to which contributions under paragraph (1) or para-
graph (2) (as the case may be) may be made.’’. 
(d) EFFECTIVE DATE.—The amendments made by 
this section shall apply to contributions made after De-
cember 31, 2013. 
SEC. 7. HSA FUNDS FOR PREMIUMS FOR HIGH DEDUCT-
IBLE HEALTH PLANS. 
(a) IN GENERAL.—Subparagraph (C) of section 
223(d)(2) of the Internal Revenue Code of 1986 is amend-
ed by striking ‘‘or’’ at the end of clause (iii), by striking 
the period at the end of clause (iv) and inserting ‘‘, or’’, 
and by adding at the end the following: 
‘‘(v) a high deductible health plan if— 
‘‘(I) such plan is not offered in 
connection with a group health plan, 
and 
‘‘(II) no portion of any premium 
(within the meaning of applicable pre-
mium under section 4980B(f)(4)) for 
such plan is excludable from gross in-
come under section 106.’’. 
(b) EFFECTIVE DATE.—The amendment made by 
subsection (a) shall apply to premiums for a high deduct-
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ible health plan for periods beginning after December 31, 
2013. 
SEC. 8. REQUIRING GREATER COORDINATION BETWEEN 
HIGH DEDUCTIBLE HEALTH PLAN ADMINIS-
TRATORS AND HSA ACCOUNT ADMINISTRA-
TORS SO THAT ENROLLEES CAN ENROLL IN 
BOTH AT THE SAME TIME. 
The Secretary of the Treasury, through the issuance 
of regulations or other guidance, shall encourage adminis-
trators of health plans and trustees of health savings ac-
counts to provide for simultaneous enrollment in high de-
ductible health plans and setup of health savings accounts. 
SEC. 9. SPECIAL RULE FOR CERTAIN MEDICAL EXPENSES 
INCURRED BEFORE ESTABLISHMENT OF AC-
COUNT. 
(a) IN GENERAL.—Subsection (d) of section 223 of 
the Internal Revenue Code of 1986 is amended by redesig-
nating paragraph (4) as paragraph (5) and by inserting 
after paragraph (3) the following new paragraph: 
‘‘(4) TREATMENT OF ACCOUNT ESTABLISHED 
BEFORE
TAX
RETURN
DUE
FOR
TAX
YEAR.—For 
purposes of this section, if, before the time pre-
scribed by law for filing the return of tax for a tax-
able year (not including extensions thereof), a tax-
payer— 
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‘‘(A) establishes a health savings account, 
‘‘(B) makes contributions to a health sav-
ings account on account of such taxable year, or 
‘‘(C) makes payments or distributions from 
a health savings account for such taxable year, 
the health savings account shall be deemed to be es-
tablished on the last day of such taxable year and 
such contributions and distributions shall be deemed 
to have been made on account of such taxable 
year.’’. 
(b) CONFORMING AMENDMENT.—Paragraph (5) of 
section 223(d) of such Code, as redesignated by subsection 
(a), is amended by striking subparagraph (B) and redesig-
nating subparagraphs (C) through (E) as subparagraphs 
(B) through (D), respectively. 
(c) EFFECTIVE DATE.—The amendments made by 
this section shall apply with respect to health savings ac-
counts established, and contributions to and distributions 
from health savings accounts after, the date of the enact-
ment of this Act. 
SEC. 10. PROVISIONS RELATING TO MEDICARE. 
(a) INDIVIDUALS OVER AGE 65 ONLY ENROLLED IN 
MEDICARE PART A.—Section 223(b)(7) of the Internal 
Revenue Code of 1986 (relating to contribution limitation 
on Medicare eligible individuals) is amended by adding at 
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the end the following new sentence: ‘‘This paragraph shall 
not apply to any individual during any period the individ-
ual’s only entitlement to such benefits is an entitlement 
to hospital insurance benefits under part A of title XVIII 
of such Act pursuant to an enrollment for such hospital 
insurance benefits under section 226(a)(1) of such Act.’’. 
(b) MEDICARE BENEFICIARIES PARTICIPATING
IN 
MEDICARE ADVANTAGE MSA MAY CONTRIBUTE THEIR 
OWN MONEY TO THEIR MSA.—Subsection (b) of section 
138 of such Code is amended by striking paragraph (2) 
and by redesignating paragraphs (3) and (4) as para-
graphs (2) and (3), respectively. 
(c) EFFECTIVE DATE.—The amendments made by 
this section shall apply to taxable years beginning after 
the date of the enactment of this Act. 
SEC. 11. INDIVIDUALS ELIGIBLE FOR VETERANS BENEFITS 
FOR A SERVICE-CONNECTED DISABILITY. 
(a) IN GENERAL.—Section 223(c)(1) of the Internal 
Revenue Code of 1986 (defining eligible individual) is 
amended by adding at the end the following new subpara-
graph: 
‘‘(C) SPECIAL RULE FOR INDIVIDUALS ELI-
GIBLE
FOR
CERTAIN
VETERANS
BENEFITS.— 
For purposes of subparagraph (A)(ii), an indi-
vidual shall not be treated as covered under a 
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health plan described in such subparagraph 
merely because the individual receives periodic 
hospital care or medical services for a service- 
connected disability under any law administered 
by the Secretary of Veterans Affairs but only if 
the individual is not eligible to receive such care 
or services for any condition other than a serv-
ice-connected disability.’’. 
(b) EFFECTIVE DATE.—The amendment made by 
this section shall apply to taxable years beginning after 
the date of the enactment of this Act. 
SEC. 12. INCREASE THE MAXIMUM CONTRIBUTION LIMIT 
TO AN HSA TO MATCH DEDUCTIBLE AND 
OUT-OF-POCKET EXPENSE LIMITATION. 
(a) SELF-ONLY COVERAGE.—Subparagraph (A) of 
section 223(b)(2) of the Internal Revenue Code of 1986 
is amended by striking ‘‘$2,250’’ and inserting ‘‘the 
amount in effect under subsection (c)(2)(A)(ii)(I)’’. 
(b) FAMILY COVERAGE.—Subparagraph (B) of sec-
tion 223(b)(2) of such Code is amended by striking 
‘‘$4,500’’ and inserting ‘‘the amount in effect under sub-
section (c)(2)(A)(ii)(II)’’. 
(c) EFFECTIVE DATE.—The amendments made by 
this section shall apply to taxable years beginning after 
the date of the enactment of this Act. 
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SEC. 13. FSA FUNDS MAY BE USED FOR LONG-TERM CARE 
INSURANCE PREMIUMS. 
(a) IN GENERAL.—Subsection (c) of section 106 of 
the Internal Revenue Code of 1986 is amended by redesig-
nating paragraph (2) as paragraph (3) and by amending 
so much of such subsection as precedes such paragraph 
(3) to read as follows: 
‘‘(c) 
LONG-TERM
CARE
BENEFITS
PROVIDED 
THROUGH FLEXIBLE SPENDING ARRANGEMENTS.— 
‘‘(1) IN GENERAL.—Effective on and after Jan-
uary 1, 2013, gross income of an employee shall not 
include employer-provided coverage for qualified 
long-term care services (as defined in section 
7702B(c)) to the extent that such coverage is pro-
vided through a flexible spending or similar arrange-
ment. 
‘‘(2) PREMIUMS FOR LONG-TERM CARE.—Quali-
fied medical expenses for which reimbursement may 
be made by distributions from a flexible spending ar-
rangement shall include amounts paid for long-term 
care coverage.’’. 
(b) EFFECTIVE DATE.—The amendment made by 
this section shall apply to taxable years beginning after 
December 31, 2013. 
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SEC. 14. INDIVIDUALS ELIGIBLE FOR TRICARE. 
(a) IN GENERAL.—Section 223(c)(1) of the Internal 
Revenue Code of 1986 (defining eligible individual), as 
amended by section 11, is amended by adding at the end 
the following new subparagraph: 
‘‘(D) SPECIAL RULE FOR INDIVIDUALS EL-
IGIBLE FOR ASSISTANCE UNDER TRICARE.—For 
purposes of subparagraph (A)(ii), an individual 
shall not be treated as covered under a health 
plan described in such subparagraph merely be-
cause the individual is eligible to receive hos-
pital care, medical services, or prescription 
drugs under TRICARE Extra or TRICARE 
Standard and such individual is not enrolled in 
TRICARE Prime.’’. 
(b) EFFECTIVE DATE.—The amendment made by 
this section shall apply to taxable years beginning after 
the date of the enactment of this Act. 
SEC. 15. CERTAIN PHYSICIAN FEES TO BE TREATED AS 
MEDICAL CARE. 
(a) IN GENERAL.—Subsection (d) of section 213 of 
the Internal Revenue Code of 1986 is amended by adding 
at the end the following new paragraph: 
‘‘(12) PRE-PAID PHYSICIAN FEES.—The term 
‘medical care’ shall include amounts paid by patients 
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to their primary physician in advance for the right 
to receive medical services on an as-needed basis.’’. 
(b) EFFECTIVE DATE.—The amendment made by 
this section shall apply to taxable years beginning after 
the date of the enactment of this Act. 
SEC. 16. ALLOW BOTH SPOUSES TO MAKE CATCH-UP CON-
TRIBUTIONS TO THE SAME HSA ACCOUNT. 
(a) IN GENERAL.—Paragraph (3) of section 223(b) 
of the Internal Revenue Code of 1986 is amended by add-
ing at the end the following new subparagraph: 
‘‘(C) 
SPECIAL
RULE
WHERE
BOTH 
SPOUSES ARE ELIGIBLE INDIVIDUALS WITH 1 
ACCOUNT.—If— 
‘‘(i) an individual and the individual’s 
spouse have both attained age 55 before 
the close of the taxable year, and 
‘‘(ii) the spouse is not an account ben-
eficiary of a health savings account as of 
the close of such year, 
the additional contribution amount shall be 200 
percent of the amount otherwise determined 
under subparagraph (B).’’. 
(b) EFFECTIVE DATE.—The amendment made by 
this section shall apply to taxable years beginning after 
the date of the enactment of this Act. 
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SEC. 17. HIGH DEDUCTIBLE HEALTH PLANS RENAMED AS 
HSA QUALIFIED HEALTH PLANS. 
(a) IN GENERAL.—The following sections of the In-
ternal Revenue Code of 1986 are each amended by strik-
ing ‘‘high deductible health plan’’ each place it appears 
and inserting ‘‘HSA qualified health plan’’: 
(1) Section 26(b)(2)(S). 
(2) Paragraphs (3) and (5)(B)(ii) of section 
106(e). 
(3) Section 223. 
(4) Section 408(d)(9). 
(b) SPECIAL RULES.—The amendments made by this 
section, the matter being inserted shall bear the same 
case, number, font, and font size as the matter being re-
placed. 
Æ 
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