NABIP-MA Past President, Bill Stuart, heads to Washington D.C. to fight on behalf of NABIP-MA Members!

NABIP-MA’s Past President and current Region 1 Chair, Bill Stuart spent two days last week in the nation’s capital speaking with legislative aides and committee staffers in Congress about Health Savings Account provisions in the One Big, Beautiful Bill Act. He formally represented the American Bankers Association HSA Council in the meetings, but the issue is important to benefits and insurance professionals and their clients whom the NABIP-MA chapter supports.

The House of Representatives sent to the Senate a reconciliation bill with 10 provisions to expand and enhance HSAs. The proposed changes represent about $43 billion in cost (lost revenue to the federal Treasury) in a $4 trillion bill. Senate Finance Committee chair Mike Crapo (R-ID) stripped all 10 HSA provisions, legislation to make Individual-Coverage HRAs (ICHRAs) permanent, and other healthcare provisions from the House draft. This despite the fact that a recent Harvard CAPS/Harris Poll found that these provisions scored the highest favorability ratings in the bill. The HSA provisions were supported by 68% of Democrats, 77% of Republicans, and 67% of unenrolled voters.

The HSA provisions would allow otherwise-eligible working seniors enrolled on Medicare Part A to remain HSA-eligible; define Bronze and catastrophic plans as HSA-qualified; permit patients in a direct-primary care arrangement to remain HSA-eligible; permit HSA owners to reimburse tax-free certain fitness club membership fees and exercise equipment; and increase contributions for lower-income owners. The last two provisions account for about $20 in lost federal revenue, or nearly half the total cost of the 10 HSA items.

Bill and his colleagues delivered a simple message to the aides with whom they met:

1.    Restore the HSA provisions. They are popular across the political spectrum.

2. If the Senate must cut some of the items, the top priorities should be the working seniors and Bronze/catastrophic provisions. The working seniors provision would end discrimination based on age and income (working seniors who must collect Social Security benefits to meet their budget are auto-enrolled on Part A, which disqualifies them from making or receiving HSA contributions). Defining Bronze and catastrophic plans as HSA-qualified would open this tax opportunity to many of the more than 7.2 million Americans covered on these plans through government-facilitated marketplaces.

Left unsaid: The provisions to reimburse fitness club dues and equipment and to permit higher contributions have little support among HSA administrators and employers. But politics often trumps policy. The fitness provision is strongly supported by the chair of the House Ways and Means Committee and the Senate majority leader.

What’s next? The Senate will release its draft of the reconciliation bill. Depending on content, the Trump Administration, which is HSA-friendly, may inject itself into the policy discussion. A bill does not become law until the House and Senate pass identical drafts and the president signs the legislation. We may be living in the second act of a five-act play that will run for the next two to four weeks.