What the Big Beautiful Bill Did (and Did Not Do) for HSAs

You and your clients may have heard and been excited about several proposed HSA enhancements in the One Big Beautiful Bill Act (OBBB). Unfortunately, not all of them made the cut. So we thought we’d share some quick info to let you know what actually made it into law, what didn’t pass, and why it matters.

What Didn’t Make the Final Bill

As Kiplinger explains, these proposed HSA improvements were ultimately excluded:

• Contributions for people who have Medicare Part A remain disallowed. This is unfortunate since the Part A deductible and the minimum HSA deductible are roughly the same.
• Income-based extra contribution levels did not pass. This proposal would have allowed people with lower incomes to contribute more to their HSAs as a way to make the tax benefits more accessible and help them save more for future medical expenses.
• Spousal catch-up contributions into a single HSA remain disallowed. Couples age 55 and older will continue to have to open separate accounts if they both want to make the $1,000 catch-up contribution.
• Using HSAs for fitness or wellness expenses (like gym memberships) without a doctor’s note was removed from the final version.

What Did Make the Final Bill

These provisions are law, effective starting late 2025 or early 2026:

1. Telehealth Safe Harbor Becomes Permanent

The OBBB retroactively makes permanent the COVID-era rule allowing HDHPs to cover telehealth services before the deductible without affecting HSA eligibility. This means clients with high-deductible plans can access virtual care benefits right from the start of the year without first meeting their deductible, making it more affordable.

Read more about this provision in AHCP’s August 1 blog post.

2. Direct Primary Care (DPC) Is HSA-Compatible

Starting in 2026, clients can use HSA funds to pay for DPC membership fees up to $150/month for individuals or $300/month for families without losing HSA eligibility, as long as the services are limited to primary care and meet federal guidelines. This change removes the current barrier that disqualifies DPC members from contributing to an HSA. Soon, they’ll not only be able to keep contributing but also cover membership costs with tax-free dollars.

3. Bronze and Catastrophic ACA Plans Become HSA-Compatible

Starting January 1, 2026, bronze and catastrophic plans purchased through the ACA Marketplace will be treated as HDHPs, even if they don’t meet the traditional HDHP deductible and cost-sharing rules. This change makes these plans HSA-eligible and allows millions of individuals, especially younger or cost-conscious ones, to pair these lower-premium plans with tax-advantaged HSA contributions for the first time.

Three Steps in the Right Direction

While many promising proposals didn’t make it through final negotiations, the changes that did, especially those affecting telehealth, DPC, and ACA marketplace plans, give clients more ways to use HSAs in 2026 and beyond. For agents, understanding these changes will help you guide clients toward smarter healthcare and tax-saving choices.