Health savings accounts have become one of the more active areas of federal health policy over the past year, with GOP lawmakers pushing to expand eligibility and use the tax-advantaged accounts as a vehicle for broader consumer-driven healthcare reform.
Four notes on where HSA policy stands:
1. The One Big Beautiful Bill Act, enacted last summer, included a permanent safe harbor for pre-deductible telehealth and remote care, the designation of ACA bronze and catastrophic plans as HSA-compatible, and clarification that certain direct primary care arrangements do not disqualify people from HSA eligibility as of 2026. HSA funds can also be used tax-free to pay DPC fees, as long as monthly fees are less than $150 for individuals or $300 for families.
2. In December, the Senate failed to advance both a Democratic proposal for a three-year extension of the now-expired enhanced ACA premium tax credits, along with a Republican alternative pitch that would have contributed federal funds to HSAs.
According to CMS, bronze plan selections have risen from 30% of consumers in 2025 to 40% in 2026, while silver plan selections have declined from 56% to 43% after silver had held roughly steady from 2021 through 2025. Because bronze and catastrophic plans are now HSA-eligible, a larger share of ACA enrollees now have HSA-compatible plans.
3. For 2026, individuals with a HDHP can contribute up to $4,400 into their HSA, up from $4,300 in 2025, and those with family coverage can contribute up to $8,750, up from $8,550 last year. The catch-up contribution limit for those 55 and up remains at $1,000.
4. The Great American Health Alliance (GAHA), a newly formed 501(c)(4) nonprofit, said in March it is supportive of the Trump administration’s “Great Healthcare Plan,” which was introduced in January and calls for the elimination of direct ACA subsidy payments to insurers in favor of sending funds to eligible Americans to purchase health coverage.
Founding members of GAHA include HealthEquity, one of the largest HSA administrators by number of accounts, along with OpenLoop Health and the Alliance of Health Care Sharing Ministries. The organization is led by Keith Nahigian, a Republican political consultant who has worked on six presidential campaigns.
On HSAs specifically, GAHA supports the HSAs For All Act, which would decouple HSA eligibility from HDHPs, and the Personal Health Investment Today Act, which would expand eligible HSA expenses to include gym memberships and nutrition programs.
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