The House has expanded the potential for HSA, FSA and HRA – an alphabet soup of possibilities.    Some Democrats have argued against expansion (as they did against the inception of these programs), claiming that they do not help the working class, but a number of them voted for approval of this new bill, which passed 277 to 142.  The changes:

  • Over the counter drugs may now be purchased through all three of these plans
  • Menstrual care products are also now qualified medical expenses for reimbursement
  • Gym memberships and the cost to participate in certain physical exercise programs will be treated as qualified medical expenses to a limit of $500 per year single or $1,000 joint
  • HSA contributions will be raised to $6,650 single and $13,300 for families
  • Working seniors participating in Medicare Part A may now continue to contribute to HSA
  • Spouses over age 55 may also make “catch up” contributions to an HSA
  • Individuals may contribute to an HSA even if they are in an FSA
  • At employer’s discretion, participant may roll over unused FSA balance to an HSA (though this would be capped at $2,650 individual and $5,300 for families)
  • Health FSA balances could be carried over to the following year (maximum 3 x the annual FSA contribution limit)
  • Health plans can now provide “first dollar” coverage up to $250 ($500 for family)
  • A Direct Primary Care service can be considered as a health plan for reimbursement
  • Employer may offer free or discounted medical services without violating HSA rules