Bill Could Give Low-Income ACA Exchange Plan Users HSAs

For 2023, the maximum annual out-of-pocket spending limit for an individual’s covered services is $9,100.

The government provides cost-sharing reduction subsidies to help people with income from 100% to 250% of the federal poverty level cope with the cost-sharing bills.

H.R. 5608: The new bill would let an exchange plan enrollee who wanted an HSA get a high-deductible “silver level” exchange plan — or policy designed to pay about 70% of the value of a standard package of benefits — and an HSA tied to a medical debit card.

The patient would have to use the debit card to have the HSA pay for current medical expenses. The patient could have the HSA pay for dental care, vision care and hearing care as well as other types of health care.

The program would go live in 2025, and the bill would pay for an HSA option public education program.

The amount contributed to the HSA for an enrollee who stuck with the HSA option for a full year could exceed $1,000.

Congressional Research Service analysts recently noted that the value of the cost-sharing reduction subsidies can vary widely but might reduce the annual deductible for a Kansas resident with income at 150% of the federal poverty level by $4,850, to $550.

Analysts at KFF estimated that, for a household of one with income between 200% and 250% of the federal poverty level, the cost-sharing reduction subsidy could reduce the annual out-of-pocket spending maximum by $1,450, to $7,250.

Legislative mechanics: Steube has lined up one cosponsor for the bill, Rep. Kat Cammack, R-Fla.

The bill is under the jurisdiction of the House Ways and Means and House Energy and Commerce committees.

Americans for Prosperity, a group that believes in reducing federal government spending and pruning federal government regulations, is supporting the bill.

Rep. Greg Steube, R-Fla. Credit: Steube