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119-hr-1157119th CongressWALLET

ACCESS Act

Sponsored By: Representative Steube, W. Gregory [R-FL-17]

Introduced

Summary

Creates an option to deliver the value of cost‑sharing reductions as monthly Health Savings Account (HSA) deposits instead of reduced cost‑sharing, with federal reimbursement tied to premium tax credits. This would let eligible people in Exchange high‑deductible plans elect monthly HSA payments equal to one‑twelfth of the annual reduced cost‑sharing actuarial equivalent while the issuer is reimbursed by the Secretary of the Treasury.

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Bill Overview

Analyzed Economic Effects

3 provisions identified: 1 benefits, 0 costs, 2 mixed.

Silver plans must offer HDHP option

If a silver plan on the Marketplace is not a high‑deductible plan, the insurer would have to offer an actuarially equivalent HDHP alternative. HDHPs would need to make HSA payments when an eligible enrollee chooses that option. The plan’s value would count those HSA payments when actuarial value is set. The HDHP definition would stay the same as current IRS rules. This would apply for months starting after December 31, 2025.

Insurer HSA deposits count as tax credit

If enacted, any insurer deposits to your HSA under this option would count as advance Premium Tax Credit. That could change what you owe or your refund when you file taxes. The credit would be treated as higher by the amount that would have been paid using your actual household income for the tax year. This would apply for months starting after December 31, 2025.

HSA deposits instead of lower copays

If you enroll in a Marketplace high‑deductible plan, you could choose HSA money instead of lower copays. The insurer would put in 1/12 of the plan’s yearly reduced cost‑sharing value each month. The government would reimburse the insurer. You would not get cost‑sharing reductions for those months. In months a deposit is made, you could only spend from that HSA using a medical debit card for eligible medical care. Insurers and the Marketplace would also have to give you information about this option and how to open and use an HSA starting January 1, 2026. These rules would apply for months beginning after December 31, 2025.

Sponsors & CoSponsors

Sponsor

Steube, W. Gregory [R-FL-17]

FL • R

Cosponsors

  • Rep. Cammack, Kat [R-FL-3]

    FL • R

    Sponsored 2/10/2025

  • Rep. Kennedy, Mike [R-UT-3]

    UT • R

    Sponsored 12/11/2025

  • Rep. Wittman, Robert J. [R-VA-1]

    VA • R

    Sponsored 2/11/2026

Roll Call Votes

No roll call votes available for this bill.

View on Congress.gov
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