[Congressional Bills 110th Congress]
[From the U.S. Government Publishing Office]
[H.R. 7166 Introduced in House (IH)]







110th CONGRESS
  2d Session
                                H. R. 7166

         To improve access to health care and health insurance.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                           September 26, 2008

   Mr. Sali introduced the following bill; which was referred to the 
Committee on Ways and Means, and in addition to the Committee on Energy 
    and Commerce, for a period to be subsequently determined by the 
  Speaker, in each case for consideration of such provisions as fall 
           within the jurisdiction of the committee concerned

_______________________________________________________________________

                                 A BILL


 
         To improve access to health care and health insurance.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

    (a) Short Title.--This Act may be cited as the ``American Health 
Care Access Improvement, Portability, and Cost Reduction Act of 2008''.
    (b) Table of Contents.--The table of contents for this Act is as 
follows:

Sec. 1. Short title; table of contents.
Sec. 2. Nonrefundable credit for certain primary health services 
                            providers serving health professional 
                            shortage areas.
Sec. 3. Increase in Medicare physician payments through 2010.
Sec. 4. Refundable credit for health insurance coverage.
Sec. 5. Health reimbursement arrangements and spending arrangements in 
                            combination with health savings accounts.
Sec. 6. Increase in annual HSA contribution limitation.
Sec. 7. Purchase of health insurance from HSA account.
Sec. 8. Special rule for certain medical expenses incurred before 
                            establishment of account.
Sec. 9. Provisions relating to Medicare.
Sec. 10. Individuals eligible for veterans benefits for a service-
                            connected disability.
Sec. 11. Allow both spouses to make catch-up contributions to the same 
                            HSA account.
Sec. 12. FSA and HRA Termination to fund HSAs.
Sec. 13. Including information on advance directives in Medicare & You 
                            Handbook.
Sec. 14. Restoring access requirements for certain MA private fee-for-
                            service plan provisions as in existence 
                            before Public Law 110-275.

SEC. 2. NONREFUNDABLE CREDIT FOR CERTAIN PRIMARY HEALTH SERVICES 
              PROVIDERS SERVING HEALTH PROFESSIONAL SHORTAGE AREAS.

    (a) In General.--Subpart A of part IV of subchapter A of chapter 1 
of the Internal Revenue Code of 1986 (relating to nonrefundable 
personal credits) is amended by inserting after section 25D the 
following new section:

``SEC. 25E. PRIMARY CARE PHYSICIANS PROVIDERS SERVING HEALTH 
              PROFESSIONAL SHORTAGE AREAS.

    ``(a) Allowance of Credit.--In the case of an individual who is a 
qualified primary care physician or qualified nurse practitioner for 
any month during the taxable year, there shall be allowed as a credit 
against the tax imposed by this chapter for such taxable year an amount 
equal to $1,000 for each month during such taxable year--
            ``(1) which is part of the eligible service period of such 
        individual, and
            ``(2) for which such individual is a qualified primary care 
        physician or qualified nurse practitioner, respectively.
    ``(b) Qualified Primary Care Physician.--For purposes of this 
section, the term `qualified primary care physician' means, with 
respect to any month, any physician who is certified for such month by 
the Bureau to be a primary health services provider or a licensed 
mental health provider who--
            ``(1) is providing primary health services full time and 
        substantially all of whose primary health services are provided 
        in a health professional shortage area,
            ``(2) is not receiving during the calendar year which 
        includes such month a scholarship under the National Health 
        Service Corps Scholarship Program or the Indian health 
        professions scholarship program or a loan repayment under the 
        National Health Service Corps Loan Repayment Program or the 
        Indian Health Service Loan Repayment Program,
            ``(3) is not fulfilling service obligations under such 
        Programs, and
            ``(4) has not defaulted on such obligations.
    ``(c) Eligible Service Period.--For purposes of this section, the 
term `eligible service period' means the period of 60 consecutive 
calendar months beginning with the first month the taxpayer is a 
qualified primary care physician or qualified nurse practitioner.
    ``(d) Other Definitions and Special Rule.--For purposes of this 
section--
            ``(1) Bureau.--The term `Bureau' means the Bureau of 
        Primary Health Care, Health Resources and Services 
        Administration of the United States Department of Health and 
        Human Services.
            ``(2) Physician.--The term `physician' has the meaning 
        given to such term by section 1861(r) of the Social Security 
        Act.
            ``(3) Primary health services provider.--The term `primary 
        health services provider' means a provider of basic health 
        services (as described in section 330(b)(1)(A)(i) of the Public 
        Health Service Act).
            ``(4) Qualified nurse practitioner.--The term `qualified 
        nurse practitioner' means a nurse practitioner (as defined in 
        section 1861(aa)(5) of the Social Security Act) who is 
        providing primary health services full time and substantially 
        all of whose primary health services are provided in a health 
        professional shortage area.
            ``(5) Health professional shortage area.--The term `health 
        professional shortage area' means any area which, as of the 
        beginning of the eligible service period, is a health 
        professional shortage area (as defined in section 332(a)(1) of 
        the Public Health Service Act) taking into account only the 
        category of health services provided by the qualified primary 
        care physician or qualified nurse practitioner, as applicable.
            ``(6) Only 60 months taken into account.--In no event shall 
        more than 60 months be taken into account under subsection (a) 
        by any individual for all taxable years.''
    (b) Clerical Amendment.--The table of sections for subpart A of 
part IV of subchapter A of chapter 1 of the Internal Revenue Code of 
1986 is amended by inserting after the item relating to section 25D the 
following new item:

``25E. Primary care physicians serving health professional shortage 
                            areas.''.
    (c) Effective Date.--The amendments made by this section shall 
apply to taxable years beginning after December 31, 2007.

SEC. 3. INCREASE IN MEDICARE PHYSICIAN PAYMENTS THROUGH 2010.

    Section 1848(d)(9) of the Social Security Act (42 U.S.C. 1395w-
4(d)(9)), as added by section 131(a)(1)(B) of the Medicare Improvements 
for Patients and Providers Act of 2008 (Public Law 110-275), is 
amended--
            (1) in subparagraph (A), by striking ``for 2009'' and 
        inserting ``for each of 2009 and 2010''; and
            (2) in subparagraph (B), by striking ``2010'' and inserting 
        ``2011''.

SEC. 4. REFUNDABLE CREDIT FOR HEALTH INSURANCE COVERAGE.

    (a) In General.--Subpart C of part IV of subchapter A of chapter 1 
of the Internal Revenue Code of 1986 (relating to refundable credits) 
is amended by redesignating section 37 as section 38 and by inserting 
after section 36 the following new section:

``SEC. 37. QUALIFIED HEALTH INSURANCE CREDIT.

    ``(a) Allowance of Credit.--In the case of an individual, there 
shall be allowed as a credit against the tax imposed by this chapter 
for the taxable year the sum of the monthly limitations determined 
under subsection (b) for the taxpayer and the taxpayers spouse and 
dependents.
    ``(b) Monthly Limitation.--
            ``(1) In general.--The monthly limitation for each month 
        during the taxable year for an eligible individual is \1/12\th 
        of--
                    ``(A) the applicable adult amount, in the case that 
                the eligible individual is the taxpayer or the 
                taxpayer's spouse,
                    ``(B) the applicable adult amount, in the case that 
                the eligible individual is an adult dependent, and
                    ``(C) the applicable child amount, in the case that 
                the eligible individual is a child dependent.
            ``(2) Limitation on aggregate amount.--Notwithstanding 
        paragraph (1), the aggregate monthly limitations for the 
        taxpayer and the taxpayer's spouse and dependents for any month 
        shall not exceed \1/12\th of the applicable aggregate amount.
            ``(3) No credit for ineligible months.--With respect to any 
        individual, the monthly limitation shall be zero for any month 
        for which such individual is not an eligible individual.
    ``(c) Applicable Amounts.--For purposes of this section--
            ``(1) Applicable adult amount.--The term `applicable adult 
        amount' means $2,500.
            ``(2) Applicable child amount.--The term `applicable child 
        amount' means $1,000.
            ``(3) Applicable aggregate amount.--The term `applicable 
        aggregate amount' means $5,000.
    ``(d) Eligible Individual.--For purposes of this section--
            ``(1) In general.--The term `eligible individual' means, 
        with respect to any month, an individual who--
                    ``(A) is the taxpayer, the taxpayer's spouse, or 
                the taxpayer's dependent, and
                    ``(B) is covered under qualified health insurance 
                as of the 1st day of such month.
            ``(2) Coverage under medicare, medicaid, schip, military 
        coverage.--The term `eligible individual' shall not include any 
        individual for a month if, as of the first day of such month, 
        such individual is--
                    ``(A) entitled to benefits under part A of title 
                XVIII of the Social Security Act or enrolled under part 
                B of such title, and the individual is not a 
                participant or beneficiary in a group health plan or 
                large group health plan that is a primary plan (as 
                defined in section 1862(b)(2)(A) of such Act),
                    ``(B) in the case of a State that has not made the 
                election described in section 1939(a)(1)(B) of the 
                Social Security Act, enrolled in the program under 
                title XIX of such Act (other than under section 1928 of 
                such Act), or
                    ``(C) entitled to benefits under chapter 55 of 
                title 10, United States Code.
            ``(3) Identification requirements.--The term `eligible 
        individual' shall not include any individual for any month 
        unless the policy number associated with the qualified refund 
        eligible health insurance and the TIN of each eligible 
        individual covered under such health insurance for such month 
        are included on the return of tax for the taxable year in which 
        such month occurs.
            ``(4) Prisoners.--The term `eligible individual' shall not 
        include any individual for a month if, as of the first day of 
        such month, such individual is imprisoned under Federal, State, 
        or local authority.
            ``(5) Aliens.--The term `eligible individual' shall not 
        include any alien individual for a month if, as of the first 
        day of such month, such individual is not a lawful permanent 
        resident of the United States.
    ``(e) Qualified Health Insurance.--For purposes of this section--
            ``(1) In general.--The term `qualified health insurance' 
        means any insurance constituting medical care which (as 
        determined under regulations prescribed by the Secretary) 
        provides coverage for inpatient and outpatient care, emergency 
        benefits, and physician care.
            ``(2) Certain coverage disregarded.--Such term does not 
        include any insurance--
                    ``(A) substantially all of the coverage of which is 
                coverage described in section 223(c)(1)(B), or
                    ``(B) which constitutes medical care under any 
                health plan maintained by any employer (or former 
                employer) of the taxpayer or the taxpayer's spouse.
    ``(f) Other Definitions.--For purposes of this section--
            ``(1) Dependent.--The term `dependent' has the meaning 
        given such term by section 152 (determined without regard to 
        subsections (b)(1), (b)(2), and (d)(1)(B) thereof). An 
        individual who is a child to whom section 152(e) applies shall 
        be treated as a dependent of the custodial parent for a 
        coverage month unless the custodial and noncustodial parent 
        agree otherwise.
            ``(2) Adult.--The term `adult' means an individual who is 
        not a child.
            ``(3) Child.--The term `child' means a qualifying child (as 
        defined in section 152(c)).
    ``(g) Special Rules.--
            ``(1) Coordination with medical deduction, etc.--Any amount 
        paid by a taxpayer for insurance to which subsection (a) 
        applies shall not be taken into account in computing the amount 
        allowable to the taxpayer as a credit under section 35 or as a 
        deduction under section 213(a).
            ``(2) Medical and health savings accounts.--The credit 
        allowed under subsection (a) for any taxable year shall be 
        reduced by the aggregate amount distributed from Archer MSAs 
        (as defined in section 220(d)) and health savings accounts (as 
        defined in section 223(d)) which are excludable from gross 
        income for such taxable years by reason of being used to pay 
        premiums for coverage of an eligible individual (as defined in 
        subsection (e)) under qualified health insurance (as defined in 
        subsection (f)) for any month.
            ``(3) Denial of credit to dependents.--No credit shall be 
        allowed under this section to any individual with respect to 
        whom a deduction under section 151 is allowable to another 
        taxpayer for a taxable year beginning in the calendar year in 
        which such individuals taxable year begins.
            ``(4) Married couples must file joint return.--
                    ``(A) In general.--If the taxpayer is married at 
                the close of the taxable year, the credit shall be 
                allowed under subsection (a) only if the taxpayer and 
                his spouse file a joint return for the taxable year.
                    ``(B) Marital status; certain married individuals 
                living apart.--Rules similar to the rules of paragraphs 
                (3) and (4) of section 21(e) shall apply for purposes 
                of this paragraph.
            ``(5) Verification of coverage, etc.--No credit shall be 
        allowed under this section with respect to any individual 
        unless such individual's coverage (and such related information 
        as the Secretary may require) is verified in such manner as the 
        Secretary may prescribe.
            ``(6) Insurance which covers other individuals; treatment 
        of payments.--Rules similar to the rules of paragraphs (7) and 
        (8) of section 35(g) shall apply for purposes of this section.
    ``(h) Coordination With Advance Payments.--
            ``(1) Reduction in credit for advance payments.--With 
        respect to any taxable year, the amount which would (but for 
        this subsection) be allowed as a credit to the taxpayer under 
        subsection (a) shall be reduced (but not below zero) by the 
        aggregate amount paid on behalf of such taxpayer under section 
        7527A for months beginning in such taxable year.
            ``(2) Recapture of excess advance payments.--If the 
        aggregate amount paid on behalf of the taxpayer under section 
        7527A for months beginning in the taxable year exceeds the sum 
        of the monthly limitations determined under subsection (b) for 
        the taxpayer and the taxpayer's spouse and dependents for such 
        months, then the tax imposed by this chapter for such taxable 
        year shall be increased by the sum of--
                    ``(A) such excess, plus
                    ``(B) interest on such excess determined at the 
                underpayment rate established under section 6621 for 
                the period from the date of the payment under section 
                7527A to the date such excess is paid.
        For purposes of subparagraph (B), an equal part of the 
        aggregate amount of the excess shall be deemed to be 
        attributable to payments made under section 7527A on the first 
        day of each month beginning in such taxable year, unless the 
        taxpayer establishes the date on which each such payment giving 
        rise to such excess occurred, in which case subparagraph (B) 
        shall be applied with respect to each date so established.
    ``(i) Annual Inflation Adjustment.--In the case of any taxable year 
beginning in a calendar year after 2009, each of the dollar amounts 
contained in subsection (c) shall be annually increased by the annual 
inflation adjustment determined under subparagraph (B) section 
1809(c)(2) of the Social Security Act for such calendar year. Any 
adjustment under the preceding sentence shall be rounded in the manner 
described in subparagraph (A) of such section.''.
    (b) Advance Payment of Credit.--Chapter 77 (relating to 
miscellaneous provisions) of such Code is amended by inserting after 
section 7527 the following new section:

``SEC. 7527A. ADVANCE PAYMENT OF QUALIFIED HEALTH INSURANCE CREDIT.

    ``(a) In General.--The Secretary shall establish a program for 
making payments on behalf of individuals to providers of qualified 
health insurance (as defined in section 37(e)) for such individuals.
    ``(b) Limitation.--The Secretary may make payments under subsection 
(a) only to the extent that the Secretary determines that the amount of 
such payments made on behalf of any taxpayer for any month does not 
exceed the sum of the monthly limitations determined under section 37 
for the taxpayer and taxpayer's spouse and dependents for such 
month.''.
    (c) Information Reporting.--
            (1) In general.--Subpart B of part III of subchapter A of 
        chapter 61 of such Code (relating to information concerning 
        transactions with other persons) is amended by inserting after 
        section 6050V the following new section:

``SEC. 6050W. RETURNS RELATING TO QUALIFIED HEALTH INSURANCE CREDIT.

    ``(a) Requirement of Reporting.--Every person who is entitled to 
receive payments for any month of any calendar year under section 7527A 
(relating to advance payment of qualified health insurance credit) with 
respect to any individual shall, at such time as the Secretary may 
prescribe, make the return described in subsection (b) with respect to 
each such individual.
    ``(b) Form and Manner of Returns.--A return is described in this 
subsection if such return--
            ``(1) is in such form as the Secretary may prescribe, and
            ``(2) contains, with respect to each individual referred to 
        in subsection (a)--
                    ``(A) the name, address, and TIN of each such 
                individual,
                    ``(B) the months for which amounts payments under 
                section 7527A were received,
                    ``(C) the amount of each such payment,
                    ``(D) the type of insurance coverage provide by 
                such person with respect to such individual and the 
                policy number associated with such coverage,
                    ``(E) the name, address, and TIN of the spouse and 
                each dependent covered under such coverage, and
                    ``(F) such other information as the Secretary may 
                prescribe.
    ``(c) Statements To Be Furnished to Individuals With Respect to 
Whom Information Is Required.--Every person required to make a return 
under subsection (a) shall furnish to each individual whose name is 
required to be set forth in such return a written statement showing--
            ``(1) the name and address of the person required to make 
        such return and the phone number of the information contact for 
        such person, and
            ``(2) the information required to be shown on the return 
        with respect to such individual.
The written statement required under the preceding sentence shall be 
furnished on or before January 31 of the year following the calendar 
year for which the return under subsection (a) is required to be made.
    ``(d) Returns Which Would Be Required To Be Made by 2 or More 
Persons.--Except to the extent provided in regulations prescribed by 
the Secretary, in the case of any amount received by any person on 
behalf of another person, only the person first receiving such amount 
shall be required to make the return under subsection (a).''.
            (2) Assessable penalties.--
                    (A) Subparagraph (B) of section 6724(d)(1) 
                (relating to definitions) of such Code is amended by 
                redesignating clauses (xv) through (xxi) as clauses 
                (xvi) through (xxii), respectively, and by inserting 
                after clause (xiv) the following new clause:
                            ``(xv) section 6050W (relating to returns 
                        relating to qualified health insurance 
                        credit),''.
                    (B) Paragraph (2) of section 6724(d) of such Code 
                is amended by striking the period at the end of 
                subparagraph (CC) and inserting ``, or'' and by 
                inserting after subparagraph (CC) the following new 
                subparagraph:
            ``(DD) section 6050W (relating to returns relating to 
        qualified health insurance credit).''.
    (d) Conforming Amendments.--
            (1) Paragraph (2) of section 1324(b) of title 31, United 
        States Code, is amended by inserting ``37,'' after ``36,''.
            (2) The table of sections for subpart C of part IV of 
        subchapter A of chapter 1 of the Internal Revenue Code of 1986 
        is amended by redesignating the item relating to section 37 as 
        an item relating to section 38 and by inserting after the item 
        relating to section 36 the following new item:

``Sec. 37. Qualified health insurance credit.''.
            (3) The table of sections for chapter 77 of such Code is 
        amended by inserting after the item relating to section 7527 
        the following new item:

``Sec. 7527A. Advance payment of qualified health insurance credit.''.
            (4) The table of sections for subpart B of part III of 
        subchapter A of chapter 61 of such Code is amended by adding at 
        the end the following new item:

``Sec. 6050W. Returns relating to qualified health insurance credit.''.
    (e) Effective Date.--The amendments made by this section shall 
apply to taxable years beginning after December 31, 2008.

SEC. 5. HEALTH REIMBURSEMENT ARRANGEMENTS AND SPENDING ARRANGEMENTS IN 
              COMBINATION WITH HEALTH SAVINGS ACCOUNTS.

    (a) In General.--Subparagraph (B) of section 223(c)(1) of the 
Internal Revenue Code of 1986 (relating to certain coverage 
disregarded) is amended by striking ``and'' at the end of clause (ii), 
by striking the period at the end of clause (iii) and inserting ``, 
and'', and by inserting after clause (iii) the following new clause:
                            ``(iv) coverage under a flexible spending 
                        arrangement or a health reimbursement 
                        arrangement, or both, which meets the 
                        requirements of paragraph (6).''.
    (b) Combination Health Reimbursement, Savings, and Spending 
Arrangements.--Subsection (c) of section 223 of such Code (relating to 
definitions and special rules) is amended by adding at the end the 
following new paragraph:
            ``(6) Combined limit for contributions or credits to health 
        reimbursement, arrangements and spending arrangements.--
                    ``(A) In general.--In the case of coverage under a 
                flexible spending arrangement or a health reimbursement 
                arrangement, or both, such coverage meets the 
                requirements of this paragraph if, with respect to an 
                individual--
                            ``(i) the sum of--
                                    ``(I) the amount allowable as a 
                                deduction under subsection (a),
                                    ``(II) the salary reduction amount 
                                elected by the individual and, if 
                                applicable, the employer contribution 
                                or credit allocated to the individual 
                                for the taxable year under the flexible 
                                spending arrangement (as defined in 
                                section 106(c)(2)), plus
                                    ``(III) the amounts that the 
                                individual is permitted, under the 
                                terms of the plan, to receive in 
                                reimbursements for the taxable year 
                                under the health reimbursement 
                                arrangement, does not exceed
                            ``(ii) the sum of the annual deductible and 
                        the other annual out-of-pocket expenses (other 
                        than for premiums) required to be paid under 
                        the plan by the eligible individual for covered 
                        benefits.
                    ``(B) Exceptions for disregarded coverage.--For 
                purposes of subparagraph (A)--
                            ``(i) Certain flexible spending 
                        arrangements.--Any flexible spending 
                        arrangement salary reduction amounts or 
                        employer contributions or credits that are 
                        restricted by the employer to use for coverage 
                        described in paragraph (1)(B) shall not be 
                        taken into account under subparagraph 
                        (A)(i)(II).
                            ``(ii) Certain health reimbursement 
                        arrangements.--Any reimbursements from a health 
                        reimbursement arrangement for coverage 
                        described in paragraph (1)(B) shall not be 
                        taken into account under subparagraph 
                        (A)(i)(III).
                            ``(iii) Qualified hsa distributions from 
                        fsa and hra terminations.--Any qualified HSA 
                        distribution (as defined in section 106(e)) 
                        shall not be taken into account under 
                        subparagraph (A)(i).
                    ``(C) Termination.--Coverage shall not be treated 
                as meeting the requirements of this paragraph for any 
                taxable year beginning after December 31, 2012.''.
    (c) Effective Date.--The amendments made by this section shall 
apply to taxable years beginning after December 31, 2007.

SEC. 6. INCREASE IN ANNUAL HSA CONTRIBUTION LIMITATION.

    (a) In General.--Paragraph (2) of section 223(b) of the Internal 
Revenue Code of 1986 (relating to monthly limitation) is amended--
            (1) in subparagraph (A) by striking ``$2,250'' and 
        inserting ``$4,500'', and
            (2) in subparagraph (B) by striking ``$4,500'' and 
        inserting ``$9,000''.
    (b) Cost-of-Living Adjustment.--Section 223(g)(1)(B)(i) of such 
Code is amended by striking ``calendar year 1997'' and inserting 
``calendar year 2008''.
    (c) Effective Date.--The amendments made by this section shall 
apply to taxable years beginning after December 31, 2007.

SEC. 7. PURCHASE OF HEALTH INSURANCE FROM HSA ACCOUNT.

    (a) In General.--Paragraph (2) of section 223(d) of the Internal 
Revenue Code of 1986 (defining qualified medical expenses) is amended--
            (1) by striking subparagraphs (B) and (C),
            (2) in subparagraph (A) by striking ``(a) in general.--'' 
        and moving the text 2 ems to the left, and
            (3) by inserting `` and including payment for insurance)'' 
        after ``section 213(d)''.
    (b) Effective Date.--The amendments made by this section shall 
apply with respect to insurance purchased after the date of the 
enactment of this Act in taxable years beginning after such date.

SEC. 8. SPECIAL RULE FOR CERTAIN MEDICAL EXPENSES INCURRED BEFORE 
              ESTABLISHMENT OF ACCOUNT.

    (a) In General.--Subsection (d) of section 223 of the Internal 
Revenue Code of 1986 is amended by redesignating paragraph (4) as 
paragraph (5) and by inserting after paragraph (3) the following new 
paragraph:
            ``(4) Certain medical expenses incurred before 
        establishment of account treated as qualified.--
                    ``(A) In general.--For purposes of paragraph (2), 
                an expense shall not fail to be treated as a qualified 
                medical expense solely because such expense was 
                incurred before the establishment of the health savings 
                account if such expense was incurred during the 60-day 
                period beginning on the date on which the high 
                deductible health plan is first effective.
                    ``(B) Special rules.--For purposes of subparagraph 
                (A)--
                            ``(i) an individual shall be treated as an 
                        eligible individual for any portion of a month 
                        for which the individual is described in 
                        subsection (c)(1), determined without regard to 
                        whether the individual is covered under a high 
                        deductible health plan on the 1st day of such 
                        month, and
                            ``(ii) the effective date of the health 
                        savings account is deemed to be the date on 
                        which the high deductible health plan is first 
                        effective after the date of the enactment of 
                        this paragraph.''.
    (b) Effective Date.--The amendment made by this section shall apply 
with respect to insurance purchased after the date of the enactment of 
this Act in taxable years beginning after such date.

SEC. 9. PROVISIONS RELATING TO MEDICARE.

    (a) Individuals Over Age 65 Only Enrolled in Medicare Part A.--
Section 223(b)(7) of the Internal Revenue Code of 1986 (relating to 
contribution limitation on Medicare eligible individuals) is amended by 
adding at the end the following new sentence: ``This paragraph shall 
not apply to any individual during any period the individual's only 
entitlement to such benefits is an entitlement to hospital insurance 
benefits under part A of title XVIII of such Act pursuant to an 
enrollment for such hospital insurance benefits under section 226(a)(1) 
of such Act.''.
    (b) Medicare Beneficiaries Participating in Medicare Advantage MSA 
May Contribute Their Own Money to Their MSA.--Subsection (b) of section 
138 of such Code is amended by striking paragraph (2) and redesignating 
paragraphs (3) and (4) as paragraphs (2) and (3), respectively.
    (c) Effective Date.--The amendments made by this section shall 
apply to taxable years beginning after the date of the enactment of 
this Act.

SEC. 10. INDIVIDUALS ELIGIBLE FOR VETERANS BENEFITS FOR A SERVICE-
              CONNECTED DISABILITY.

    (a) In General.--Section 223(c)(1) of the Internal Revenue Code of 
1986 (defining eligible individual) is amended by adding at the end the 
following new subparagraph:
                    ``(D) Special rule for individuals eligible for 
                certain veterans benefits.--For purposes of 
                subparagraph (A)(ii), an individual shall not be 
                treated as covered under a health plan described in 
                such subparagraph merely because the individual 
                receives periodic hospital care or medical services for 
                a service-connected disability under any law 
                administered by the Secretary of Veterans Affairs but 
                only if the individual is not eligible to receive such 
                care or services for any condition other than a 
                service-connected disability.''.
    (b) Effective Date.--The amendments made by this section shall 
apply to taxable years beginning after the date of the enactment of 
this Act.

SEC. 11. ALLOW BOTH SPOUSES TO MAKE CATCH-UP CONTRIBUTIONS TO THE SAME 
              HSA ACCOUNT.

    (a) In General.--Paragraph (3) of section 223(b) of the Internal 
Revenue Code of 1986 is amended by adding at the end the following new 
subparagraph:
                    ``(C) Special rule where both spouses are eligible 
                individuals with 1 account.--If--
                            ``(i) an individual and the individual's 
                        spouse have both attained age 55 before the 
                        close of the taxable year, and
                            ``(ii) the spouse is not an account 
                        beneficiary of a health savings account as of 
                        the close of such year,
                the additional contribution amount shall be 200 percent 
                of the amount otherwise determined under subparagraph 
                (B).''.
    (b) Effective Date.--The amendments made by this section shall 
apply to taxable years beginning after the date of the enactment of 
this Act.

SEC. 12. FSA AND HRA TERMINATION TO FUND HSAS.

    (a) Grace Period Not Required.--Section 106(e)(2) of the Internal 
Revenue Code of 1986 is amended by adding at the end the following new 
sentence: ``A distribution shall not fail to be treated as a qualified 
HSA distribution merely because the balance in such arrangement is 
determined without regard to the requirement that unused amounts 
remaining at the end of a plan year must be forfeited in the absence of 
a grace period.''.
    (b) Deposit in Limited FSA or HRA of Funds in Excess FSA or HRA 
Termination Distribution.--Paragraph (1) of section 106(e) of such Code 
is amended by inserting before the period at the end thereof the 
following: ``and the deposit of funds in excess of a qualified HSA 
distribution amount into a health flexible spending account or health 
reimbursement arrangement which is compatible with a health savings 
account and which, on the date of such distribution, is a part of the 
employer's plan''.
    (c) Disclaimer of Disqualifying Coverage.--Subparagraph (B) of 
section 223(c)(1) of such Code is amended by striking ``and'' at the 
end of clause (ii), by striking the period at the end of clause (iii) 
and inserting ``, and'', and by inserting after clause (iii) the 
following new clause:
                            ``(iv) any coverage (whether actual or 
                        prospective) otherwise described in 
                        subparagraph (A)(ii) which is disclaimed at the 
                        time of the creation or organization of the 
                        health savings account.''.
    (d) Effective Date.--The amendments made by this section shall 
apply to taxable years beginning after the date of the enactment of 
this Act.

SEC. 13. INCLUDING INFORMATION ON ADVANCE DIRECTIVES IN MEDICARE & YOU 
              HANDBOOK.

    (a) In General.--Section 1804(a) of the Social Security Act (42 
U.S.C. 1395b-2(a)) is amended--
            (1) in paragraph (2), at the end by striking ``and'';
            (2) in paragraph (3), at the end by striking the period and 
        inserting ``; and''; and
            (3) by inserting after paragraph (3), the following new 
        paragraph:
            ``(4) educational information about advance directives (as 
        defined in section 1866(f)(3)).''.
    (b) Effective Date.--The amendments made by subsection (a) shall 
apply to information distributed for years beginning on or after the 
date of the enactment of this Act.

SEC. 14. RESTORING ACCESS REQUIREMENTS FOR CERTAIN MA PRIVATE FEE-FOR-
              SERVICE PLAN PROVISIONS AS IN EXISTENCE BEFORE PUBLIC LAW 
              110-275.

    (a) In General.--Section 1852(d) of the Social Security Act (42 
U.S.C. 1395w-22(d)), as amended by section 162(a) of the Medicare 
Improvements for Patients and Providers Act of 2008 (Public Law 110-
275), is amended--
            (1) in paragraph (4), in the second sentence--
                    (A) by striking ``Subject to paragraphs (5) and 
                (6), the Secretary'' and inserting ``The Secretary''; 
                and
                    (B) in subparagraph (B), by striking ``sufficient 
                number and range of providers within such category to 
                meet the access standards in subparagraphs (A) through 
                (E) of paragraph (1)'' and inserting ``sufficient 
                number and range of providers within such category to 
                provide covered services under the terms of the plan''; 
                and
            (2) by striking paragraphs (5) and (6).
    (b) Clarification Regarding Utilization.--Section 1859(b)(2) of the 
Social Security Act (42 U.S.C. 1395w-28(b)(2)), as amended by section 
162(b) of the Medicare Improvements for Patients and Providers Act of 
2008 (Public Law 110-275), is amended by striking ``Nothing in 
subparagraph (B)'' through ``specified preventive or screening 
services.''.
                                 <all>