The Affordable Care Act ("health reform") was signed into law in 2010 and made two changes to HSAs: 1) In 2011, over-the-counter medications were no longer eligible for tax-free withdrawal unless obtained with a prescription (except for insulin). 2) In 2011, the excise tax for non-qualified HSA withdrawals increased from 10% to 20%. The CARES act, which passed March 27, 2020 restored the ability to use HSAs to purchase certain OTC drugs and medications, like aspirin and other pain medications, allergy medication, etc., without a doctor's prescription.