The orig­i­nal idea of HDH­Ps was to cre­ate a con­sumer-direct­ed vehi­cle (Health Sav­ings Account), which would “force” pol­i­cy­hold­ers to shop more con­scious­ly for health ser­vices.  Whether that has or has not suc­ceed­ed is always a mat­ter of con­jec­ture and even debate, but what is clear is that there are oth­er ser­vices that did not exist in abun­dance at the time the law was passed.  Now the IRS has pro­posed amend­ments under Doc­u­ment 2020–12213 which qual­i­fies the fol­low­ing expens­es as “med­ical care” for HSA reimbursement

  • Direct pri­ma­ry care arrangements
  • The pre­mi­ums paid for “cov­er­age” with a health care share min­istry are allowed