ACCESS Act
Summary
What This Bill Does
The ACCESS Act creates an alternative to Affordable Care Act reduced cost-sharing for eligible insured people enrolled in Exchange-provided high-deductible health plans. If an eligible enrollee elects the option, the ordinary section 1402 reduced cost-sharing rules do not apply for that month. Instead, the issuer must contribute to the person's health savings account one-twelfth of the annual actuarial value of the reduced cost-sharing benefit, and the Secretary reimburses the issuer. The bill turns a point-of-service cost-sharing subsidy into an HSA deposit, which gives enrollees more account control but may expose them to higher upfront costs before the HSA balance is enough.
Who Benefits and How
Exchange high-deductible plan enrollees benefit if they prefer HSA funds they can control across eligible medical expenses. HSA administrators benefit from more federally financed account contributions flowing through health savings accounts. ACA issuers benefit from a defined reimbursement mechanism for the HSA contributions they must make. Consumer-directed health care advocates benefit because the bill expands HSA use inside subsidized exchange coverage.
Who Bears the Burden and How
Low-income enrollees may bear higher point-of-service cost risk when reduced cost-sharing is replaced by monthly HSA deposits. ACA issuers must calculate, deposit, and document one-twelfth actuarial-value HSA contributions. HHS and CMS must reimburse issuers and police eligibility, elections, and monthly subsidy substitution. The Treasury Department and IRS must coordinate HSA tax rules with the new exchange subsidy option.
Key Provisions
- Creates an HSA contribution alternative to ACA reduced cost-sharing for eligible exchange enrollees.
- Requires issuers to contribute one-twelfth of the annual actuarial value to the enrollee's HSA.
- Provides federal reimbursement to issuers for required HSA contributions.
- Suspends ordinary reduced cost-sharing for months when an eligible enrollee elects the HSA option.
Evidence Chain:
This summary is generated from the full bill text using AI analysis. Expand "Detailed Analysis" below for identified beneficiaries/burden bearers with clause-level evidence links.
At a Glance
What This Bill Does
Lets eligible ACA exchange enrollees in high-deductible health plans receive HSA contributions instead of reduced cost-sharing at the point of care.
Key Policy Areas
Health Care, Tax, Insurance
Primary Purpose
Lets eligible ACA exchange enrollees in high-deductible health plans receive HSA contributions instead of reduced cost-sharing at the point of care.
Policy Domains
Resolution provisions
Identified Gains
- Exchange high-deductible plan enrollees
- HSA administrators
- ACA issuers
- Consumer-directed care advocates
Identified Costs
- Low-income enrollees
- ACA issuers
- HHS and CMS
- Treasury Department
Sponsors
Legislative Progress
In CommitteeMr. Steube (for himself and Mrs. Cammack) introduced the following …
Referred to the Committee on Ways and Means, and in …
Introduced in House
Stakeholder Effects
cui bono?How this legislation distributes effects. Mention counts reflect frequency, not effect magnitude.
Exchange HDHP enrollees, Low-income enrollees
Positive-direction: Exchange HDHP enrollees
Negative-direction: Low-income enrollees
Bill Structure & Actor Mappings
Who is "The Secretary" in each section?
We use a combination of our own taxonomy and classification in addition to large language models to assess meaning and potential beneficiaries. High confidence means strong textual evidence. Always verify with the original bill text.
Learn more about our methodology