How the “Big Beautiful Bill” impacts Health Saving Accounts

A recent federal bill includes a few key updates that impact Health Savings Accounts (HSAs), especially for people enrolled in direct primary care or planning to buy insurance through the ACA marketplace. While most proposed HSA expansions were removed from the final legislation, one important provision made it through, and more flexibility is coming in 2026.

Here’s what changed, what didn’t, and how to get the most from your HSA.

Direct Primary Care Is Now HSA-Eligible

If you’re enrolled in a high-deductible health plan (HDHP) and use an HSA, you can now spend your tax-free dollars on a direct primary care (DPC) membership. The new law allows up to $150/month for individuals or $300/month for families, with future increases tied to inflation.

This means you can now use your Healthcare Spending Card¹ to cover DPC membership fees—something that wasn’t possible under old IRS rules.

Learn more:

• IRS HSA guidelines
• Direct Primary Care Alliance overview
• How the Healthcare Spending Card works

AC Bronze and Catastrophic Plans Will Qualify in 2026

Starting in 2026, Bronze and catastrophic plans purchased through the ACA marketplace will be considered HSA-eligible. This gives more people the ability to open and contribute to an HSA even without employer-sponsored coverage.

This change could be especially valuable for freelancers, early retirees, and lower-income individuals who shop for health insurance on HealthCare.gov.

Why it matters:

• You’ll be able to contribute to an HSA with more plan types
• You’ll still get the triple tax advantage: tax-deductible contributions, tax-free growth, and tax-free withdrawals for medical expenses
• More flexibility for people outside of traditional employment

What Didn’t Make It Into the Final Bill

Several proposed updates to HSAs were excluded from the final version of the bill. These included:

• Allowing people enrolled in Medicare Part A to continue contributing to an HSA
• Letting both spouses make catch-up contributions to the same account
• Expanding HSA limits for low- and middle-income households
• Permitting HSA use at on-site employer health clinics
• Removing disqualification for individuals whose spouse has a Flexible Spending Account (FSA)

These changes were supported by many healthcare reform advocates but ultimately didn’t pass. According to Kiplinger, lawmakers pulled them due to cost concerns and budget balancing.

How to Make the Most of Your HSA Right Now

Even without the full list of proposed changes, there are still smart ways to get more out of your HSA:

• Use it for DPC: Pair your HSA with a primary care membership for better access and lower out-of-pocket costs
• Invest your balance: Many HSA providers offer investment options once your balance hits a threshold
• Pair it with the right payment tool: The Healthcare Spending Card gives you upfront access to healthcare funds with 0% financing² options
• Know your eligible expenses: Review the full list in IRS Publication 502

Final Takeaway

The recent changes to HSAs may not go as far as many hoped, but they do open new doors for patients using direct primary care or buying ACA coverage. With the right tools and a bit of planning, your HSA can be more than just a savings account—it can be a core part of your financial strategy.

Want to learn more about HSA rules, contribution strategies, or using your Healthcare Spending Card for everyday healthcare? Visit our Healthcare Spending Card page to learn more.