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[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 6183 Introduced in House (IH)]
<DOC>
119th CONGRESS
1st Session
H. R. 6183
To amend the Internal Revenue Code of 1986 to reform certain rules
related to health savings accounts.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
November 20, 2025
Mr. Doggett 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 reform certain rules
related to health savings accounts.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. REFERENCES.
Except as otherwise expressly provided, whenever in this Act an
amendment 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 provision of the Internal Revenue Code of
1986.
SEC. 2. REPEAL OF EXCEPTION TO REQUIREMENT THAT PENALTY-FREE
DISTRIBUTIONS BE FOR QUALIFIED MEDICAL EXPENSES.
(a) In General.--Section 223(f)(4) is amended by striking
subparagraph (C).
(b) Effective Date.--The amendment made by this section shall apply
to distributions made after December 31, 2025.
SEC. 3. INCOME LIMITATION ON DEDUCTIBLE CONTRIBUTIONS TO HEALTH SAVINGS
ACCOUNTS.
(a) In General.--Section 223(b) is amended by adding at the end the
following new paragraph:
``(9) Limitation based on modified adjusted gross income.--
``(A) In general.--The amount otherwise allowable
as a deduction under subsection (a) shall be reduced
(but not below zero) by an amount which bears the same
ratio to the amount so allowable (determined without
regard to this paragraph) as--
``(i) the amount (if any) by which the
taxpayer's modified adjusted gross income
exceeds the applicable income threshold, bears
to
``(ii) $40,000 ($20,000 in the case of a
married individual filing a separate return).
``(B) Applicable income threshold.--For purposes of
this paragraph, the term `applicable income threshold'
means--
``(i) in the case of a joint return or
surviving spouse (as defined in section 2(a)),
$300,000,
``(ii) in the case of a head of household,
$250,000,
``(iii) in the case of a married individual
filing a separate return, $150,000, and
``(iv) in any other case, $200,000.
``(C) Modified adjusted gross income.--For purposes
of this paragraph, the term `modified adjusted gross
income' means adjusted gross income determined without
regard to this section and sections 911, 931, and
933.''.
(b) Treatment of Non-deductible Contributions.--
(1) Rules for distribution.--Section 223(f)(2) is amended
is amended by striking ``shall be included in the gross income
of such beneficiary.'' and inserting ``shall be included in the
gross income of the beneficiary as provided in section 72.
Rules similar to the rules of section 408(d)(2) shall apply for
purposes of the preceding sentence.''.
(2) Coordination with excise tax on excess contributions.--
Section 4973(g)(1) is amended by inserting ``(determined
without regard to section 223(b)(9))'' after ``section 223''.
(c) Payroll Taxes.--
(1) FICA.--Section 3121(a) is amended by striking ``or'' at
the end of paragraph (22), by striking the period at the end of
paragraph (23) and inserting ``; or'', and by inserting afer
paragraph (23) the following new paragraph:
``(24)(A) for purposes of section 3101, any payment
excludable from the employee's gross income under section
106(d), and
``(B) for purposes of any other provision of this chapter
(including section 3102), any payment made to or for the
benefit of an employee if at the time of such payment it is
reasonable to believe that the employee will be able to exclude
such payment from income under section 106(d).''.
(2) Railroad retirement.--Section 3231(e)(11) is amended to
read as follows:
``(11)(A) for purposes of section 3201, any payment
excludable from the employee's gross income under section
106(d), and
``(B) for purposes of any other provision of this chapter
(including section 3202), any payment made to or for the
benefit of an employee if at the time of such payment it is
reasonable to believe that the employee will be able to exclude
such payment from income under section 106(d);''.
(d) Effective Date.--
(1) In general.--Except as otherwise provided in this
subsection, the amendments made by this section shall apply to
taxable years beginning after December 31, 2025.
(2) Payroll taxes.--The amendments made by subsection (c)
shall apply to payments made after December 31, 2025.
SEC. 4. HEALTH SAVINGS ACCOUNT REIMBURSEMENT OF MEDICAL EXPENSES
LIMITED TO 2 YEARS.
(a) In General.--Section 223(d)(2) is amended by adding at the end
the following new subparagraph:
``(E) Reimbursements limited to 2 years.--An amount
paid or distributed from a health savings account to
reimburse the account beneficiary for a qualified
medical expense shall not be treated as used to pay a
qualified medical expense unless such distribution is
made not later than 2 years after the date on which
such reimbursed qualified medical expense was paid.''.
(b) Effective Date.--The amendment made by this section shall apply
to amounts paid or distributed from a health savings account after
December 31, 2025.
SEC. 5. REQUIREMENT TO SUBSTANTIATE DISTRIBUTIONS FROM HEALTH SAVINGS
ACCOUNTS THAT ARE FOR QUALIFIED MEDICAL EXPENSES.
(a) In General.--Section 223(d)(2), as amended by the preceding
provisions of this Act, is amended by adding at the end the following
new subparagraph:
``(F) Substantiation requirement.--
``(i) In general.--An amount paid or
distributed from a health savings account shall
not be treated as used to pay a qualified
medical expense unless such amount is
substantiated as a qualified medical expense.
``(ii) Assessment required.--In the case of
any expense with respect to which a provider's
opinion is required to substantiate such
expense as a qualified medical expense under
clause (i), such opinion shall not constitute
substantiation unless--
``(I) such opinion is based on an
assessment conducted pursuant to a bona
fide provider-patient relationship,
``(II) such assessment is conducted
in-person or is an assessment of a type
that generally accepted standards of
medical practice do not require to be
in-person, and
``(III) the expense is incurred for
an item or service of a type that would
be typically recommended under
generally accepted standards of medical
practice.
``(G) Regulations.--The Secretary shall issue such
regulations or other guidance as may be necessary or
appropriate to carry out the purposes of this
subparagraph.''.
(b) Determination by Trustee.--Section 223(d)(1) is amended by
adding at the end the following new subparagraph:
``(F) In the case of any amount paid or distributed
from the trust, the trustee shall determine, consistent
with the requirements of paragraph (2)(F), whether such
amount has been substantiated as a qualified medical
expense.''.
(c) Effective Date.--The amendments made by this section shall
apply to amounts paid or distributed from a health savings account
after December 31, 2025.
SEC. 6. CERTAIN EXPENSES NOT TREATED AS MEDICAL CARE.
(a) In General.--Section 223(d)(2), as amended by the preceding
provisions of this Act, is amended by adding at the end the following
new subparagraph:
``(G) Exclusions.--For purposes of this paragraph,
the amounts paid for the following shall not be treated
as paid for medical care:
``(i) Spa and beauty treatments.
``(ii) So much of any amounts paid for
exercise equipment as exceed $500 in any
taxable year.''.
(b) Effective Date.--The amendment made by this section shall apply
to amounts paid or distributed from a health savings account after
December 31, 2025.
SEC. 7. EXCISE TAX ON EXCESSIVE HEALTH SAVINGS ACCOUNT FEES.
(a) In General.--Subtitle D is amended by adding at the end the
following new chapter:
``CHAPTER 50B--EXCESSIVE HEALTH SAVINGS ACCOUNT FEES
``Sec. 5000E. Excessive health savings account fees.
``SEC. 5000E. EXCESSIVE HEALTH SAVINGS ACCOUNT FEES.
``(a) In General.--There is hereby imposed on the trustee of any
health savings account which charges any excessive health savings
account fee a tax equal to the excess of--
``(1) the amount of such fee, over
``(2) the reasonable amount of such fee as determined under
subsection (b)(3).
``(b) Excessive Health Saving Account Fee.--For purposes of this
section--
``(1) Excessive health savings account fee.--The term
`excessive health savings account fee' means any covered health
savings account fee if such fee exceeds the reasonable amount
of such fee as determined under paragraph (3).
``(2) Covered health savings account fee.--The term
`covered health savings account fee' means any of the following
if charged in connection with a health savings account:
maintenance fees; transfer fees; fees for paper statements,
checks, or replacement cards; withdrawal fees; fees for
insufficient funds; fees to ensure that fees do not exceed
earnings or account balance; and such other fees or charges as
the Secretary may identify for purposes of this paragraph.
``(3) Reasonable fees.--With respect to each category of
fees described in paragraph (2) and such additional categories
or subcategories as the Secretary may provide, the Secretary
shall determine the reasonable amount of such fee.
``(c) Health Saving Account.--For purposes of this section, the
term `health savings account' has the meaning given such term in
section 223.''.
(b) Reporting.--Subpart A of part III of subchapter A of chapter 61
is amended by inserting after section 6039L the following new section:
``SEC. 6039M. INFORMATION REGARDING HEALTH SAVINGS ACCOUNT FEES.
``(a) In General.--Each trustee of a health savings account which
charges any covered health savings account fee during any calendar year
shall, for such calendar year, make a return at such time and in such
manner as the Secretary may provide setting forth the information
described in subsection (b) and such other information as the Secretary
may require.
``(b) Information.--
``(1) In general.--Each return under subsection (a) shall
include, with respect to each category of fee charged, a
description of such fee, the number of such fees charged, and
the aggregate amount of such fees charged.
``(2) Separately stated categories.--The information
described in paragraph (1) shall be separately stated based on
such demographic or other characteristics as the Secretary may
provide.
``(c) Definitions.--Terms used in this section which are also used
in section 5000E shall have the same meaning as when used in section
5000E.''.
(c) Clerical Amendments.--
(1) The table of chapters for subtitle D is amended by
adding at the end the following new item:
``Chapter 50B--Excessive Health Savings Account Fees''.
(2) The table of sections for subpart A of part III of
subchapter A of chapter 61 is amended by inserting after the
item relating to section 6039L the following new item:
``Sec. 6039M. Information regarding health savings account fees.''.
(d) Effective Date.--The amendments made by this section shall
apply to fees charged after December 31, 2025.
SEC. 8. REPORTING OF EARNINGS ON CASH BALANCES OF HEALTH SAVINGS
ACCOUNTS.
(a) In General.--Section 223(h) is amended by adding at the end the
following: ``The reports under paragraph (1) shall include a statement
specifying the average yield on cash balances in the health savings
account of the account beneficiary for the period covered by the report
and a statement of the national average yield on savings account
balances for such period (determined in such manner as the Secretary
may provide).''.
(b) Effective Date.--The amendment made by this section shall apply
to reports with respect to periods beginning after December 31, 2025.
<all>
Introduced in House
Introduced in House
Referred to the House Committee on Ways and Means.
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