Today, Americans for Tax Reform, with 32 other free market groups and advocates, released a coalition letter urging the United States Senate to keep the historic improvements to Health Savings Accounts (HSAs) made in the House-passed One, Big, Beautiful Bill Act.
The OBBBA’s HSA provisions, as written, would allow another 20 million Americans access to these tax-advantaged accounts – the most significant expansion of HSAs since they were created in 2003.
In the letter, we explain the many benefits of HSAs and detail how the OBBBA would improve upon them.
To read the letter in full, click here or see below.
June 10th, 2025
Dear Members of the U.S. Senate,
We, the undersigned organizations, write in support of the United States Senate keeping the historic improvements to Health Savings Accounts (HSAs) made in the House-passed One, Big, Beautiful Bill Act.
The OBBBA’s HSA provisions, as written, would allow another 20 million Americans access to these tax-advantaged accounts – the most significant expansion of HSAs since they were created in 2003.
Because HSAs are owned by patients, empowering them to choose the best care and most cost-effective options for their health, HSAs have become a popular and successful vehicle. HSAs are currently used in conjunction with low premium, high deductible health insurance plans (HDHPs). There are over 35.5 million HSAs, covering nearly 72 million people.
Building on this success will give Americans more control over their own health – a perfect complement to President Trump’s ‘Make America Healthy Again’ initiative.
Expanding HSAs means more Americans can save their hard-earned tax dollars, are allowed a significant vehicle for growing their savings, and are given the freedom of portability. Because HSAs promote consumer-driven healthcare, they encourage more modest healthcare spending, helping lower exorbitant costs in the American healthcare sector. One study out of Health Services Research found that HSA enrollees spent up to 7 percent less than non-HSA enrollees on medical expenses and up to 9 percent less for pharmacy spending. Further, HSA plans often have the lowest monthly premiums and competitive deductibles when compared to employer and Obamacare plans.
The House-passed reconciliation bill makes needed improvements to HSAs, expanding access to new groups, broadening and clarifying the types of care covered, and increasing contribution limits for working families.
The OBBBA Would Expand Access to HSAs
The bill allows seniors eligible for Medicare Part A to contribute to an HSA, preserving access to tax-free savings well into retirement. It would allow married couples to make catch-up contributions to the same HSA, would allow HSA participation even when one spouse has a Flexible Savings Account (FSA), and would allow families switching to HDHPs to roll over unused FSA or Health Reimbursement Account (HRA) balances directly into an HSA tax-free. The bill would also allow those with bronze and catastrophic plans, under the Affordable Care Act, to have HSAs.
The OBBBA Would Broaden HSA-Covered Care
Direct Primary Care (DPC) arrangements would be explicitly allowed, with monthly caps of $150 for individuals and $300 for families.
On-site clinics provided by employers would be able to offer preventive care, immunizations, screenings, and basic services without jeopardizing HSA eligibility. This change would empower businesses to promote wellness without triggering Internal Revenue Service (IRS) penalties for their employees.
In the spirit of “Make America Healthy Again,” the bill also allows HSA funds to be used for qualified fitness expenses, like gym memberships or exercise classes. Specifically, up to $500 per year for individuals and $1,000 for joint filers.
The OBBBA Would Increase Contribution Limits for Working-Class Households
The bill increases the annual HSA contribution limit by $4,300 for individuals and $8,550 for families. These higher limits phase out at $75,000 for single filers and $150,000 for joint returns, targeting the benefit where it’s needed most.
Not only will this historic expansion help millions of Americans, but it will also set the stage for building out Health Savings Accounts in the future.
Since they were created over 20 years ago, HSAs have proven successful in promoting healthcare choice, lowering taxes, and lowering healthcare costs. We urge members of the Senate to build on this success, retaining the House-passed HSA improvements in the One, Big, Beautiful Bill Act.
Onward,
Grover Norquist
President, Americans for Tax Reform
Paul Teller
Executive Vice President, Advancing American Freedom
Jamison Coppola
Government Relations Director, American Association of Christian Schools
Saulius “Saul” Anuzis
President, American Association of Senior Citizens
Phil Kerpen
President, American Commitment
Steve Pociask
Chief Executive Officer, The American Consumer Institute
Robert Romano
Executive Director, Americans for Limited Government
Brent Gardner
Chief Government Affairs Officer, Americans for Prosperity
Ryan Ellis
President, Center for a Free Economy
Jeffrey Mazzella
President, Center for Individual Freedom
David McIntosh
President, Club for Growth
James Edwards
Executive Director, Conservatives for Property Rights
Joel White
President, Council for Affordable Health Coverage
Tom Schatz
President, Council for Citizens Against Government Waste
Kristen A. Ullman
President, Eagle Forum
Kelly McKenna
CEO, End Chronic Disease
Annette Thompson Meeks
CEO, Freedom Foundation of Minnesota
John C. Goodman
President, Goodman Institute for Public Policy Research
Cameron Sholty
Executive Director, Heartland Impact
James Taylor
President, The Heartland Institute
Daniel Perrin
President, HSA Coalition
Carrie Lukas
President, Independent Women
Andrew Langer
President, Institute for Liberty
Seton Motley
President, Less Government
Daniel Garza
Founding President, The LIBRE Initiative
Charles Sauer
President, Market Institute
Brandon Arnold
Executive Vice President, National Taxpayers Union
Lorenzo Montanari
Executive Director, Property Rights Alliance
James Erwin
Executive Director, Digital Liberty
Interim Director, Shareholder Advocacy Forum
James L. Martin
Founder/Chairman, 60 Plus Association
Karen Kerrigan
President & CEO, Small Business & Entrepreneurship Council
Patrick D. Purtill
Executive Vice President & General Counsel, Unify.US
