With open enrollment season in full swing, more Americans than ever will be able to fund tax-advantaged accounts for medical expenses next year.
The so-called “big and beautiful” bill passed in July includes three provisions that expand access to health savings accounts for people with high-deductible health insurance plans.
This change could attract 3 million to 4 million new HSA participants in 2026, according to Morningstar estimates.
Like flexible spending accounts, HSAs are funded with pre-tax dollars and can be used to cover medical expenses throughout the year. Unlike an FSA, this money has no “use it or lose it” provisions. Rather, the funds are held in an account that you own and can be taken with you if you change jobs.
Another feature that sets HSAs apart is the ability to invest your funds in stocks, bonds, exchange-traded funds, and more. And there are significant benefits to investing that money, rather than spending it on immediate medical needs, experts say.
“HSAs are certainly one of the most powerful financial tools available, but they are underutilized, especially considering their unique triple tax benefits: contributions are tax-deductible, growth is tax-free, and withdrawals for qualified medical expenses are also tax-free,” Sean Robison, a certified financial planner and founder of Purpose Built Financial Services, previously told CNBC Make It.
HSA is expanding to three groups
Typically, you must enroll in a high-deductible plan to qualify for an HSA. In 2026, that means one with a deductible of at least $1,700 for individuals and $3,400 for families. You can’t enroll in disqualifying health insurance, enroll in Medicare, or be claimed as a dependent on someone else’s tax return.
The new bill would make three groups of people eligible for HSAs whose rules were previously vague or prohibitive.
1. Everyone who signed up for the Bronze and Catastrophic Plan
Insurance plans available on the Afforable Care Act Marketplace typically fall into one of five categories: Platinum, Gold, Silver, Bronze, and Catastrophic. In general, platinum plans have higher premiums and lower deductibles, and bronze and catastrophic plans (the latter only available to people under 30 and some people with limited incomes) have lower premiums and higher deductibles.
Until recently, enrollees in these plans could qualify for an HSA on a case-by-case basis. Under the new bill, anyone eligible for a bronze or catastrophic plan could qualify for an HSA.
Catastrophic plans are not widely available, but about 7.2 million Americans are currently covered by bronze plans, according to the Centers for Medicare and Medicaid Services.
2. People who use direct primary care services
Under the new law, people enrolled in direct primary care services are eligible for an HSA as long as their coverage meets other HDHP requirements.
In the DPC model, offered through providers such as One Medical, patients pay a recurring fee for a set of services that are not billed to insurance. This is a practice that leaves you in a legal gray area when it comes to HSA eligibility.
“It’s not so much a paradigm shift for people as it is solving a nebulous problem,” said Jake Spiegel, a senior fellow at the Employee Benefits Research Institute. “What this bill says is you can do this and still contribute to your HSA and that’s perfectly fine.”
3. Some people use telemedicine
Under pandemic-era legislation, including the CARES Act, high-deductible plans can waive deductibles for telehealth services, whether preventive or not, and still qualify for an HSA.
These rules expired at the end of 2024, but a new bill reinstated them and made them permanent.
This does not mean that a high deductible plan must offer telehealth services to enrollees in order to qualify for an HSA. Rather, such plans cannot be excluded simply because they allow participants to receive telehealth without contributing to a deductible.
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