# 119-s-4353: Health Savings Account Expansion Act

119-s-4353, Health Savings Account Expansion Act, is a 119th Congress bill sponsored by Sen. Marshall, Roger [R-KS] (R-KS); status introduced; PRIA reads it as touching household money (as of 2026-05-15).

- Canonical: https://policyrisk.com/legislation/119-s-4353
- As of: 2026-05-15
- Plain-text twin of the page above; the HTML and this file carry the same facts.

## Facts
- Bill: 119-s-4353
- Congress: 119
- Title: Health Savings Account Expansion Act
- Status: introduced
- Introduced: 2026-04-21
- Sponsor: Sen. Marshall, Roger [R-KS] (R-KS)
- Cosponsors: 0
- Policy area: Taxation
- Touches household money: yes
- Last recorded action: 2026-05-15

## Summary

**Expands eligibility for Health Savings Accounts (HSAs)**. This bill would widen who can use HSAs, revise high-deductible health plan rules, allow new prepaid medical expenses and certain premiums to be paid from HSAs, and change how health care sharing ministries are treated, and it would take effect for taxable years beginning after December 31, 2026. - Families and individuals covered by government plans would be newly eligible to use HSAs. The bill specifically includes people with Medicare Parts A, B, or C, Medicaid, the Children’s Health Insurance Program and qualified CHIP look-alikes, and certain federal employee coverage. - HSA account rules and HDHP definitions would be changed. The bill streamlines the high-deductible health plan definition and would allow HSAs to pay for certain health plan or insurance coverage and prepaid physician fees or prepaid medical services. - Members of health care sharing ministries would see a split treatment. Ministries would not be treated as health plans or insurance under the tax title, but membership fees, shared medical payments, and ministry administrative fees would count as amounts paid for medical care for tax purposes. - Over-the-counter drug reimbursements would be tightened. HSAs and Archer medical savings accounts would reimburse only prescribed medicines or insulin, not general OTC drugs.

## Provisions PRIA read

- More people could use HSAs: benefit, high. This bill would let more people be treated as eligible for a health savings account (HSA). You would be eligible for an HSA for a month if, on the first day of that month, you are covered by Medicare Part A, B, or C; Medicaid; CHIP or a qualified CHIP look-alike; certain federal employee coverage u…
- Use HSA money for prepaid care and some premiums: benefit, high. If enacted, this bill would let HSA funds pay for periodic physician fees or the right to receive services on an as-needed basis. It would also let HSA funds pay for prepaid medical services that screen, diagnose, treat, prevent disease, or promote wellness. In addition, you would be able to use HS…
- OTC drug reimbursements restricted: cost, low. If enacted, the bill would limit HSA and Archer MSA reimbursements for medicines and drugs to prescribed drugs or insulin only. Over-the-counter medicines without a prescription would no longer be reimbursable from these accounts. This change would apply for taxable years beginning after December 3…
- Changes for sharing-ministry members: mixed, medium. If enacted, the tax code would say health care sharing ministries are not treated as health insurance for tax rules starting for tax years after December 31, 2026. At the same time, if you belong to a health care sharing ministry and you pay membership, sharing, or administrative fees, you would be…

## Related bills

- 119-s-4952: Protecting American Taxpayers Act
- 119-s-4378: Protecting American Taxpayers Act
- 119-s-3903: Railway Safety Act of 2026
- 119-s-1748: Kids Online Safety Act
- 119-s-3265: Improve and Enhance the Work Opportunity Tax Credit Act
- 119-s-2140: Haskell Indian Nations University Improvement Act

## Sources
- [119-s-4353 on Congress.gov](https://www.congress.gov/bill/119th-congress/senate-bill/4353)

## Related
- [119-s-4952: Protecting American Taxpayers Act](https://policyrisk.com/legislation/119-s-4952)
- [119-s-4378: Protecting American Taxpayers Act](https://policyrisk.com/legislation/119-s-4378)
- [119-s-3903: Railway Safety Act of 2026](https://policyrisk.com/legislation/119-s-3903)
- [119-s-1748: Kids Online Safety Act](https://policyrisk.com/legislation/119-s-1748)
- [119-s-3265: Improve and Enhance the Work Opportunity Tax Credit Act](https://policyrisk.com/legislation/119-s-3265)
- [119-s-2140: Haskell Indian Nations University Improvement Act](https://policyrisk.com/legislation/119-s-2140)
- [All bills in Congress](https://policyrisk.com/legislation)

Source: PRIA, https://policyrisk.com/legislation/119-s-4353 (as of 2026-05-15).