I 
119TH CONGRESS 
1ST SESSION H. R. 4243 
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 
JUNE 27, 2025 
Mr. SMITH of Nebraska (for himself and Mr. PANETTA) 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 quali-
fied distributions from health savings accounts for cer-
tain home care expenses. 
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 ‘‘Homecare for Seniors 
Act’’. 
SEC. 2. CERTAIN HOME CARE EXPENSES TREATED AS 
QUALIFIED DISTRIBUTIONS FROM HEALTH 
SAVINGS ACCOUNTS. 
(a) IN GENERAL.—Section 223(d)(2) of the Internal 
Revenue Code of 1986 is amended— 
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(1) by striking ‘‘medical care (as defined in sec-
tion 213(d))’’ in subparagraph (A) and inserting 
‘‘specified medical care’’, and 
(2) by adding at the end the following new sub-
paragraph: 
‘‘(E) SPECIFIED
MEDICAL
CARE.—For 
purposes of this paragraph— 
‘‘(i) IN GENERAL.—The term ‘speci-
fied medical care’ means medical care (as 
defined in section 213(d)) and qualified 
home care. 
‘‘(ii) QUALIFIED
HOME
CARE.—The 
term ‘qualified home care’ means a con-
tract to provide 3 or more of the following 
services in the residence of the service re-
cipient: 
‘‘(I) Assistance with eating. 
‘‘(II) Assistance with toileting. 
‘‘(III) Assistance with transfer-
ring. 
‘‘(IV) Assistance with bathing. 
‘‘(V) Assistance with dressing. 
‘‘(VI) Assistance with continence. 
‘‘(VII) Medication adherence. 
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Such term shall not include any contract 
unless the services provided pursuant to 
such contract are provided by a service 
provider which is licensed by the State to 
provide such services or such services are 
otherwise provided in a manner that is 
consistent with State requirements. 
‘‘(iii) RELATED PARTIES.—The term 
‘qualified home care’ shall not include any 
contract which is, directly or indirectly, be-
tween a service provider and a service re-
cipient who are related within the meaning 
of section 267(b) or 707(b).’’. 
(b) EFFECTIVE DATE.—The amendments made by 
this section shall apply to amounts paid with respect to 
taxable years beginning after the date of the enactment 
of this Act. 
(c) PROMOTION
OF PUBLIC AWARENESS
OF IN- 
HOME SERVICE EXPENSES ELIGIBLE
FOR TAX-FREE 
DISTRIBUTION FROM HEALTH SAVINGS ACCOUNTS.—The 
Secretary of Health and Human Services, in consultation 
with the Secretary of the Treasury, shall carry out a cam-
paign to increase public awareness of the in-home service 
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expenses that are eligible for tax-free distribution from 
health savings accounts. 
Æ 
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