I 
111TH CONGRESS 
1ST SESSION H. R. 3610 
To amend the Internal Revenue Code of 1986 to improve access to health 
care by allowing a deduction for the health insurance costs of individuals, 
expanding health savings accounts, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
SEPTEMBER 22, 2009 
Mr. AUSTRIA (for himself, Mrs. BACHMANN, Mr. BURTON of Indiana, Mr. 
LEE of New York, Mr. KINGSTON, Mr. MANZULLO, Mr. NEUGEBAUER, 
Mr. BILBRAY, Mrs. BLACKBURN, Mr. LAMBORN, Mr. PITTS, Mr. 
HENSARLING, Mr. SCALISE, Mr. MARCHANT, Ms. FALLIN, Mr. AKIN, 
Mrs. LUMMIS, Mr. GINGREY of Georgia, Mr. POSEY, Mr. TIBERI, Mr. 
THOMPSON of Pennsylvania, Mr. CHAFFETZ, Mr. SOUDER, Mr. FLEMING, 
Mr. SESSIONS, Mr. TIAHRT, Mr. MORAN of Kansas, and Mr. CASSIDY) 
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 improve 
access to health care by allowing a deduction for the 
health insurance costs of individuals, expanding 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. 
(a) SHORT TITLE.—This Act may be cited as the 
‘‘Health Savings and Affordability Act of 2009’’. 
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(b) AMENDMENT OF 1986 CODE.—Except as other-
wise expressly provided, whenever in this Act an amend-
ment or repeal is expressed in terms of an amendment 
to, or repeal of, a section or other provision, the reference 
shall be considered to be made to a section or other provi-
sion of the Internal Revenue Code of 1986. 
SEC. 2. DEDUCTION FOR QUALIFIED HEALTH INSURANCE 
COSTS OF INDIVIDUALS. 
(a) IN GENERAL.—Part VII of subchapter B of chap-
ter 1 (relating to additional itemized deductions) is 
amended by redesignating section 224 as section 225 and 
by inserting after section 223 the following new section: 
‘‘SEC. 224. COSTS OF QUALIFIED HEALTH INSURANCE. 
‘‘(a) IN GENERAL.—In the case of an individual, 
there shall be allowed as a deduction an amount equal to 
the amount paid during the taxable year for coverage for 
the taxpayer, his spouse, and dependents under qualified 
health insurance. 
‘‘(b) QUALIFIED HEALTH INSURANCE.—For pur-
poses of this section, the term ‘qualified health insurance’ 
means insurance which constitutes medical care; except 
that such term shall not include any insurance if substan-
tially all of its coverage is of excepted benefits described 
in section 9832(c). 
‘‘(c) SPECIAL RULES.— 
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‘‘(1) COORDINATION
WITH
MEDICAL
DEDUC-
TION, ETC.—Any amount paid by a taxpayer for in-
surance to which subsection (a) applies shall not be 
taken into account in computing the amount allow-
able to the taxpayer as a deduction under section 
162(l) or 213(a). Any amount taken into account in 
determining the credit allowed under section 35 shall 
not be taken into account for purposes of this sec-
tion. 
‘‘(2) DEDUCTION NOT ALLOWED FOR SELF-EM-
PLOYMENT
TAX
PURPOSES.—The deduction allow-
able by reason of this section shall not be taken into 
account in determining an individual’s net earnings 
from self-employment (within the meaning of section 
1402(a)) for purposes of chapter 2.’’. 
(b) DEDUCTION
ALLOWED
IN
COMPUTING
AD-
JUSTED GROSS INCOME.—Subsection (a) of section 62 is 
amended by inserting before the last sentence the fol-
lowing new paragraph: 
‘‘(22) COSTS
OF
QUALIFIED
HEALTH
INSUR-
ANCE.—The deduction allowed by section 224.’’. 
(c) CLERICAL AMENDMENT.—The table of sections 
for part VII of subchapter B of chapter 1 is amended by 
redesignating the item relating to section 224 as an item 
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relating to section 225 and inserting before such item the 
following new item: 
‘‘Sec. 224. Costs of qualified health insurance.’’. 
(d) EFFECTIVE DATE.—The amendments made by 
this section shall apply to taxable years beginning after 
the date of the enactment of this Act. 
SEC. 3. ALLOW BOTH SPOUSES TO MAKE CATCH-UP CON-
TRIBUTIONS TO THE SAME HSA ACCOUNT. 
(a) IN GENERAL.—Paragraph (3) of section 223(b) 
is amended by adding at the end the following new sub-
paragraph: 
‘‘(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. 4. INCREASE IN HSA CONTRIBUTION LIMITATION. 
(a) IN GENERAL.—Subsection (b) of section 223 (re-
lating to monthly limitation) is amended— 
(1) by striking ‘‘$2,250’’ in paragraph (2)(A) 
and inserting ‘‘the amount in effect under subsection 
(c)(2)(A)(ii)(I)’’, and 
(2) by striking ‘‘$4,500’’ in paragraph (2)(B) 
and inserting ‘‘the amount in effect under subsection 
(c)(2)(A)(ii)(II)’’. 
(b) CONFORMING AMENDMENT.—Paragraph (1) of 
section 223(g) is amended by striking ‘‘subsections (b)(2) 
and’’ and inserting ‘‘subsection’’. 
(c) EFFECTIVE DATE.—The amendments made by 
this section shall apply to contributions for taxable years 
beginning after the date of the enactment of this Act. 
SEC. 5. TREATMENT OF FAMILY COVERAGE PLANS HAVING 
BOTH 
INDIVIDUAL 
AND 
FAMILY 
DEDUCTIBLES. 
(a) IN GENERAL.—Paragraph (2) of section 223(c) 
(defining high deductible plan) is amended by adding at 
the end the following new subparagraph: 
‘‘(E) FAMILY
COVERAGE
PLANS
HAVING 
BOTH
INDIVIDUAL
AND
FAMILY 
DEDUCTIBLES.—In the case of a family cov-
erage plan having a deductible (and the same 
deductible) for each covered individual and a 
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