HR6183-119

Introduced

To amend the Internal Revenue Code of 1986 to reform certain rules related to health savings accounts.

119th Congress Introduced Nov 20, 2025

Analysis under review: This bill has generated analysis that may be too generic or incomplete. Clause-level evidence remains available below.

Summary

What This Bill Does

The bill repeals the exception (subparagraph C of Section 223(f)(4)) that allowed penalty-free HSA distributions for non-medical expenses after age 65. After repeal, all non-medical HSA distributions face the 20% penalty, adds an income-based phase-out for HSA deductible contributions, and requires substantiation of HSA distributions as qualified medical expenses. It relies on reporting requirements, exemptions, tax rate changes, and tax deductions. The main policy areas are Health Care, Finance, Trade, and Healthcare.

Who Benefits and How

HSA account holders (fee reduction) could see lower costs, HSA account holders could see lower costs, and Employers making HSA contributions could see lower costs.

Who Bears the Burden and How

Financial institutions serving as HSA trustees could lose revenue opportunities, High-income HSA holders (above income thresholds) could face higher costs, and HSA holders age 65 and over using accounts for non-medical expenses could face higher costs.

Key Provisions

  • Repeals the exception (subparagraph C of Section 223(f)(4)) that allowed penalty-free HSA distributions for non-medical expenses after age 65. After repeal, all non-medical HSA distributions face the 20% penalty...
  • Adds an income-based phase-out for HSA deductible contributions.
  • Requires substantiation of HSA distributions as qualified medical expenses.
  • Exempts excludes spa and beauty treatments from qualifying as medical care for HSA purposes. Caps exercise equipment reimbursement at 500 dollars per taxable year.
  • Amends Subtitle D of the IRC to add a new excise tax on HSA trustees who charge excessive fees.

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

The bill repeals the exception (subparagraph C of Section 223(f)(4)) that allowed penalty-free HSA distributions for non-medical expenses after age 65. After repeal, all non-medical HSA distributions face the 20% penalty, adds an income-based phase-out for HSA deductible contributions, and requires substantiation of HSA distributions as qualified medical expenses.

Key Policy Areas

Health Care, Finance, Trade, Healthcare

Primary Purpose

The bill repeals the exception (subparagraph C of Section 223(f)(4)) that allowed penalty-free HSA distributions for non-medical expenses after age 65. After repeal, all non-medical HSA distributions face the 20% penalty, adds an income-based phase-out for HSA deductible contributions, and requires substantiation of HSA distributions as qualified medical expenses.

Policy Domains

Health Care Finance Trade Healthcare

HSA Reform Act

Identified Gains
  • HSA account holders (fee reduction)
  • HSA account holders
  • Employers making HSA contributions
Model: codex-gpt-5:bulk-repair | Version: bill_summary_v2 | Source: ih
HSA account holders:
Employers making HSA contributions:
HSA account holders (fee reduction):
Identified Costs
  • Financial institutions serving as HSA trustees
  • High-income HSA holders (above income thresholds)
  • HSA holders age 65 and over using accounts for non-medical expenses
  • HSA account holders
  • Spa and beauty treatment providers
Model: codex-gpt-5:bulk-repair | Version: bill_summary_v2 | Source: ih
HSA account holders:
Spa and beauty treatment providers:
Financial institutions serving as HSA trustees: , , ,
High-income HSA holders (above income thresholds):
HSA holders age 65 and over using accounts for non-medical expenses:

Legislative Progress

Introduced
Introduced Committee Passed
Nov 20, 2025

Mr. Doggett introduced the following bill; which was referred to …

Stakeholder Effects

cui bono?

How this legislation distributes effects. Mention counts reflect frequency, not effect magnitude.

General Public
6 mentions across 6 clauses
+2 positive -4 negative

HSA account holders, HSA account holders (fee reduction), HSA holders age 65 and over using accounts for non-medical expenses

HSA account holders faces effects in multiple directions

Positive-direction: HSA account holders (fee reduction)

Negative-direction: HSA holders age 65 and over using accounts for non-medical expenses, HSA holders who use accounts for spa/beauty/exercise expenses, High-income HSA holders (above income thresholds)

Depository Credit Intermediation
5 mentions across 5 clauses
-5 negative

Financial institutions serving as HSA trustees, HSA trustees and financial institutions

Offices Of Physicians
1 mention across 1 clause
-1 negative

Telehealth-only medical providers for HSA substantiation

Business
1 mention across 1 clause
+1 positive

Employers making HSA contributions

Personal Care Services
1 mention across 1 clause
-1 negative

Spa and beauty treatment providers

Manufacturing
1 mention across 1 clause
-1 negative

Exercise equipment manufacturers and retailers

8/10
sections analyzed
Full impact breakdown

Bill Structure & Actor Mappings

Who is "The Secretary" in each section?

Domains
Health Care Finance Trade Healthcare
Actor Mappings
"the_secretary"
→ Secretary of the Treasury

Key Definitions

Terms defined in this bill

4 terms
"applicable income threshold" §3

,000 for joint filers, ,000 for head of household, ,000 for married filing separately, ,000 for all others.

"modified adjusted gross income" §3_magi

Adjusted gross income determined without regard to section 223 and sections 911, 931, and 933 of the IRC.

"covered health savings account fee" §7_covered_fee

Maintenance fees, transfer fees, paper statement/check/card replacement fees, withdrawal fees, insufficient funds fees, fees to ensure fees do not exceed earnings, and other fees identified by the Secretary.

"excessive health savings account fee" §7_excessive_fee

Any covered HSA fee that exceeds the reasonable amount as determined by the Secretary.

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