I 
115TH CONGRESS 
2D SESSION 
H. R. 6937 
To amend the Internal Revenue Code of 1986 to improve health savings 
accounts, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
SEPTEMBER 27, 2018 
Mr. BERA (for himself and Ms. KUSTER of New Hampshire) introduced the 
following bill; which was referred to the Committee on Ways and Means, 
and in addition to the Committee on Energy and Commerce, for a period 
to be subsequently determined by the Speaker, in each case for consider-
ation of such provisions as fall within the jurisdiction of the committee 
concerned 
A BILL 
To amend the Internal Revenue Code of 1986 to 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 ‘‘Health Savings Mod-
ernization Act of 2018’’. 
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SEC. 2. HIGH DEDUCTIBLE PLAN SAFE HARBOR FOR AB-
SENCE OF DEDUCTIBLE FOR CERTAIN COV-
ERAGE. 
(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) SAFE HARBOR FOR ABSENCE OF DE-
DUCTIBLE FOR CERTAIN OTHER CARE.—A plan 
shall not fail to be treated as a high deductible 
health plan by reason of failing to have a de-
ductible for— 
‘‘(i) a defined number of visits for 
outpatient primary care, mental health 
care, behavioral health care, or urgent 
care, or 
‘‘(ii) a generic or preferred prescrip-
tion drug formulary.’’. 
(b) EFFECTIVE DATE.—The amendment made by 
this section shall apply to plan years beginning after the 
date of the enactment of this Act. 
SEC. 3. MEDICAL EXPENSES OF YOUNG ADULT CHILDREN. 
(a) IN GENERAL.—The first sentence of section 
223(d)(2)(A) of the Internal Revenue Code of 1986 is 
amended by striking ‘‘and any dependent’’ and all that 
follows through ‘‘thereof) of such individual’’ and inserting 
‘‘and any child (as defined in section 152(f)(1)) of such 
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individual who as of the end of the taxable year has not 
attained age 27’’. 
(b) EFFECTIVE DATE.—The amendments made by 
this section shall apply to taxable years beginning after 
the date of the enactment of this Act. 
SEC. 4. EXCESS HEALTH INSURANCE COVERAGE CREDIT 
PAYABLE TO HEALTH SAVINGS ACCOUNT. 
(a) IN GENERAL.—Chapter 77 of the Internal Rev-
enue Code of 1986 is amended by adding at the end the 
following: 
‘‘SEC. 7529. EXCESS HEALTH INSURANCE COVERAGE CRED-
IT PAYABLE TO HEALTH SAVINGS ACCOUNT. 
‘‘(a) IN GENERAL.—At the request of an eligible tax-
payer, the Secretary shall make a payment to the trustee 
of the designated health savings account with respect to 
such taxpayer in an amount equal to the sum of the ex-
cesses (if any) described in subsection (c)(2) with respect 
to months in the taxable year. 
‘‘(b) DESIGNATED HEALTH SAVINGS ACCOUNT.— 
The term ‘designated health savings account’ means a 
health savings account of an individual described in sub-
section (c)(3) which is identified by the eligible taxpayer 
for purposes of this section. 
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‘‘(c) ELIGIBLE TAXPAYER.—The term ‘eligible tax-
payer’ means, with respect to any taxable year, any tax-
payer if— 
‘‘(1) such taxpayer is allowed a credit under 
section 36B for such taxable year, 
‘‘(2) the amount described in subparagraph (B) 
of section 36B(b)(2) exceeds the amount described 
in subparagraph (A) of such section with respect to 
such taxpayer applied with respect to any month 
during such taxable year, and 
‘‘(3) the taxpayer, the taxpayer’s spouse, or any 
dependent (as defined in section 152) of the tax-
payer were eligible individuals (as defined in section 
223(c)(1)) for one or more months during such tax-
able year. 
‘‘(d) CONTRIBUTIONS
TREATED
AS
ROLLOVERS, 
ETC.— 
‘‘(1) IN GENERAL.—Any amount paid the Sec-
retary to a health savings account under this section 
shall be treated for purposes of this title in the same 
manner as a rollover contribution described in sec-
tion 223(f)(5). 
‘‘(2) COORDINATION
WITH
LIMITATION
ON 
ROLLOVERS.—Any amount described in paragraph 
(1) shall not be taken into account in applying sec-
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any payment under this section to such health sav-
ings account. 
‘‘(g) ADVANCE PAYMENT.—To the extent that the 
Secretary determines feasible, payment under this section 
may be made in advance on a monthly basis under rules 
similar to the rules under section 1412 of the Patient Pro-
tection and Affordable Care Act. The Secretary, in con-
sultation with the Secretary of Health and Human Serv-
ices, shall issue guidance on Exchanges (established under 
the Patient Protection and Affordable Care Act) facili-
tating the deposit of amounts to designated health savings 
account under this section.’’. 
(b) CONFORMING AMENDMENTS.— 
(1) Section 162(l) of such Code is amended by 
adding at the end the following new paragraph: 
‘‘(6) COORDINATION WITH HEALTH INSURANCE 
COVERAGE CREDIT.—The deduction otherwise allow-
able to a taxpayer under paragraph (1) for any tax-
able year shall be reduced (but not below zero) by 
the sum of— 
‘‘(A) the amount of the credit allowable to 
such taxpayer under section 36B (determined 
without regard to subsection (f)(1) thereof) for 
such taxable year, plus 
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‘‘(B) the aggregate payments made with 
respect to the taxpayer under section 7529 for 
months during such taxable year.’’. 
(2) Section 1324(b)(2) of title 31, United 
States Code is amended by striking ‘‘or 6431’’ and 
inserting ‘‘6431, or 7529’’. 
(3) The table of sections for chapter 77 of such 
Code is amended by adding at the end the following 
new items: 
‘‘Sec. 7529. Excess Health Insurance Coverage Credit Payable To Health Sav-
ings Account.’’. 
(c) EFFECTIVE DATE.—The amendments made by 
this section shall apply to months beginning after the date 
of the enactment of this Act, in taxable years ending after 
such date. 
SEC. 5. ALLOWING ALL INDIVIDUALS PURCHASING HEALTH 
INSURANCE IN THE INDIVIDUAL MARKET 
THE OPTION TO PURCHASE A LOWER PRE-
MIUM 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 
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(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 so redesig-
nated, 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 including en-
rollees in plans described in section 1302(e)’’ after ‘‘Ex-
change’’. 
(c) REQUIREMENT TO OFFER ADDITIONAL COV-
ERAGE.—Section 2707 of the Public Health Service Act 
(42 U.S.C. 300gg–6) is amended by adding at the end 
the following new subsection: 
‘‘(e) LIMITATION
ON
CATASTROPHIC
PLANS.—A 
health insurance issuer may not offer a catastrophic plan 
(as defined in subsection (e) of section 1302 of the Patient 
Protection and Affordable Care Act) to an individual un-
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less such issuer also offers health insurance coverage to 
such individual that provides either the bronze, silver, 
gold, or platinum level of coverage described in subsection 
(d) of such section.’’. 
(d) 
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)’’. 
(e) EFFECTIVE DATE.—The amendments made by 
this section shall apply with respect to plan years begin-
ning after the date of the enactment of this Act. 
SEC. 6. HIGH DEDUCTIBLE HEALTH PLAN MAXIMUM OUT- 
OF-POCKET LIMITATION. 
(a) 
IN
GENERAL.—Section 
223(c)(2)(A)(ii) 
is 
amended by striking ‘‘does not exceed’’ and all that follows 
and inserting ‘‘does not exceed the amount in effect under 
section 1302(c) of the Patient Protection and Affordable 
Care Act’’. 
(b) 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. 7. MAXIMUM CONTRIBUTION LIMIT TO HSA IN-
CREASED TO AMOUNT OF OUT-OF-POCKET 
LIMITATION. 
(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) with respect to self-only coverage’’. 
(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) with 
respect to self-only coverage’’. 
(c) EFFECTIVE DATE.—The amendments made by 
this section shall apply to taxable years beginning after 
the date of the enactment of this Act. 
Æ 
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