I 
118TH CONGRESS 
1ST SESSION H. R. 3352 
To amend the Internal Revenue Code of 1986 to treat diapers as qualified 
medical expenses; and to prohibit States and local governments to impose 
a tax on the retail sale of diapers. 
IN THE HOUSE OF REPRESENTATIVES 
MAY 15, 2023 
Mrs. WATSON COLEMAN (for herself, Ms. LEE of California, Ms. DELAURO, 
Mr. DOGGETT, Ms. TLAIB, Mr. NICKEL, Ms. NORTON, Ms. JACKSON 
LEE, Ms. VELA´ZQUEZ, Mr. MENENDEZ, Mr. DAVIS of Illinois, Mr. LAR-
SON of Connecticut, and Mr. MULLIN) introduced the following bill; which 
was referred to the Committee on Ways and Means, and in addition to 
the Committee on the Judiciary, for a period to be subsequently deter-
mined by the Speaker, in each case for consideration of such provisions 
as fall within the jurisdiction of the committee concerned 
A BILL 
To amend the Internal Revenue Code of 1986 to treat dia-
pers as qualified medical expenses; and to prohibit States 
and local governments to impose a tax on the retail 
sale of diapers. 
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 ‘‘Improving Diaper Af-
fordability Act of 2023’’. 
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SEC. 2. FINDINGS. 
Congress finds the following: 
(1) One in 3 families with infants and toddlers 
struggles to provide the diapers their children need. 
(2) Low-income families with infants spend 14 
percent of their income on diapers alone, which is 
roughly $936 per child, per year. 
(3) Low-income families spend twice as much 
on diapers for their children, compared to families 
who have the means to buy diapers in bulk at a 
lower price. 
(4) More than 5 million children under the typ-
ical potty training age of 3-years-old live in low-in-
come families. 
(5) Diaper need affects not only the health and 
well-being of the child but it can affect the economic 
security of the entire family. 
(6) Over half of families in diaper need who 
rely on child care in order to go to work or school, 
missed work or school in the preceding month be-
cause they did not have the diapers they needed to 
put their child in child care. 
(7) No State or Federal child safety-net pro-
gram allocates dollars specifically for the purchase of 
diapers. 
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(8) Since the start of the COVID–19 pandemic, 
diaper banks around the country have experienced 
double, triple, or greater increase in demand for dia-
pers due to the pandemic and economic shutdown. 
SEC. 3. INCLUSION OF DIAPERS AS QUALIFIED MEDICAL 
EXPENSES. 
(a) 
HEALTH
SAVINGS
ACCOUNTS.—Section 
223(d)(2) of the Internal Revenue Code of 1986 is amend-
ed by adding at the end of subparagraph (A) the following: 
‘‘Notwithstanding the first sentence, amounts paid for dia-
pers shall be treated as paid for medical care.’’. 
(b) ARCHER MSAS.—Section 220(d)(2)(A) of such 
Code is amended by adding at the end the following: ‘‘Not-
withstanding the first sentence, amounts paid for diapers 
shall be treated as paid for medical care.’’. 
(c) HEALTH FLEXIBLE SPENDING ARRANGEMENTS 
AND HEALTH REIMBURSEMENT ARRANGEMENTS.—Sec-
tion 106 of such Code is amended by adding at the end 
the following new subsection: 
‘‘(h) REIMBURSEMENTS
FOR DIAPERS.—For pur-
poses of this section and section 105, expenses incurred 
for diapers shall be treated as incurred for medical care.’’. 
(d) DEPENDENT CARE ASSISTANCE AND DEPEND-
ENT CARE FLEXIBLE SPENDING ARRANGEMENTS.—Sec-
tion 129(e)(1) of such Code is amended by adding at the 
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end the following: ‘‘Such term shall include expenses in-
curred for diapers.’’. 
(e) LIMITED PURPOSE FLEXIBLE SPENDING AR-
RANGEMENTS AND HEALTH REIMBURSEMENT ARRANGE-
MENTS.—Section 223(c)(1)(B) of such Code is amended 
by striking ‘‘and’’ at the end of clause (ii), by striking 
the period at the end of clause (iii) and inserting ‘‘, and’’, 
and by adding at the end the following new clause: 
‘‘(iv) coverage under a flexible spend-
ing arrangement, or health reimbursement 
arrangement, that pays or reimburses for 
coverage described in clause (ii) (other 
than long-term care services and, in the 
case of a flexible spending arrangement, 
other than through insurance). Coverage 
shall not fail to be treated as coverage de-
scribed in the preceding sentence solely by 
reason of paying or reimbursing expenses 
incurred for diapers.’’. 
(f) EFFECTIVE DATES.— 
(1) DISTRIBUTIONS FROM HEALTH SAVINGS AC-
COUNTS.—The amendments made by subsections (a) 
and (b) shall apply to amounts paid after December 
31, 2022. 
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(2) REIMBURSEMENTS.—The amendment made 
by subsections (c) and (d) shall apply to expenses in-
curred after December 31, 2022. 
(3) LIMITED
PURPOSE
HSA
AND
HRA.—The 
amendments made by subsection (e) shall apply to 
months beginning after December 31, 2022. 
SEC. 4. PROHIBITION OF RETAIL SALES TAXES. 
A State, or unit of local government of a State, may 
not impose a sales and use tax on the retail purchase of 
diapers. 
Æ 
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