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<bill bill-stage="Introduced-in-Senate" dms-id="A1" public-private="public" slc-id="S1-OTT21088-PJC-4N-H63">
<metadata xmlns:dc="http://purl.org/dc/elements/1.1/">
<dublinCore>
<dc:title>117 S153 IS: Personalized Care Act of 2021</dc:title>
<dc:publisher>U.S. Senate</dc:publisher>
<dc:date>2021-02-02</dc:date>
<dc:format>text/xml</dc:format>
<dc:language>EN</dc:language>
<dc:rights>Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.</dc:rights>
</dublinCore>
</metadata>
<form>
<distribution-code display="yes">II</distribution-code>
<congress>117th CONGRESS</congress><session>1st Session</session>
<legis-num>S. 153</legis-num>
<current-chamber>IN THE SENATE OF THE UNITED STATES</current-chamber>
<action>
<action-date date="20210202">February 2, 2021</action-date>
<action-desc><sponsor name-id="S355">Mr. Cruz</sponsor> (for himself and <cosponsor name-id="S323">Mr. Risch</cosponsor>) introduced the following bill; which was read twice and referred to the <committee-name committee-id="SSFI00">Committee on Finance</committee-name></action-desc>
</action>
<legis-type>A BILL</legis-type>
<official-title>To amend the Internal Revenue Code of 1986 to expand and improve health savings accounts, and for other purposes.</official-title>
</form>
<legis-body display-enacting-clause="yes-display-enacting-clause" id="H0E64D16F97C84D74B9AC7AE9EF82CB61">
<section section-type="section-one" id="idE2B1E271B66F4424B083F66010F31EFF"><enum>1.</enum><header>Short title</header><text display-inline="no-display-inline">This Act may be cited as the <quote><short-title>Personalized Care Act of 2021</short-title></quote>.</text></section> <section section-type="subsequent-section" id="id25076F7331AF4054B0C1A2046C10EDC0"><enum>2.</enum><header>Health savings account eligibility</header> <subsection id="id25EBE819789B4338A5E6520485A0BC81"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">Paragraph (1) of <external-xref legal-doc="usc" parsable-cite="usc/26/223">section 223(c)</external-xref> of the Internal Revenue Code of 1986 is amended to read as follows:</text>
<quoted-block style="OLC" display-inline="no-display-inline" id="id4F3C206C721E4A66AFAD25DB99BF52BE">
<paragraph id="idE0C65A6C9B964D37ACE7A605438B21C4"><enum>(1)</enum><header>Eligible individual</header><text>The term <term>eligible individual</term> means, with respect to any month, any individual if such individual is—</text> <subparagraph id="id1036E5581BC642B691DC4B241695FDA2"><enum>(A)</enum><text>covered under—</text>
<clause id="id972878B6554A4FB3A3B96F759874F204"><enum>(i)</enum><text>a group or individual health plan,</text></clause> <clause id="id1E576EC4AFF34ECE93DE180E5240766B"><enum>(ii)</enum><text>health insurance coverage, including a short term limited duration plan or medical indemnity plan, or</text></clause>
<clause id="id657E5B636027429D919FF5A714DEBA25"><enum>(iii)</enum><text>a government plan, including coverage under the Medicare program under part A or part B of title XVIII of the Social Security Act, the Medicaid program under title XIX of such Act, the CHIP program under title XXI of such Act or a qualified CHIP look-alike program (as defined in section 2107(g) of such Act), medical coverage under <external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/10/55">chapter 55</external-xref> of title 10, United States Code (including coverage under the TRICARE program), a health care program under chapter 17 or 18 of title 38, United States Code, as determined by the Secretary of Veterans Affairs in coordination with the Secretary of Health and Human Services and the Secretary, a medical care program of the Indian Health Service or a tribal organization, or coverage under <external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/5/89">chapter 89</external-xref> of title 5, United States Code, or</text></clause></subparagraph> <subparagraph id="idFDC6ACCB91D2436BA8A5B00D1D88A2A0"><enum>(B)</enum><text>a participant in a health care sharing ministry (as defined in section 5000A(d)(2)(B)(ii)),</text></subparagraph><continuation-text continuation-text-level="paragraph">as of the 1st day of such month.</continuation-text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></subsection>
<subsection id="id39FD9C715662434386DED9C3FC953808"><enum>(b)</enum><header>Conforming amendments</header>
<paragraph id="id5B5B26F72C8C4D51BB0E194E6602C29C"><enum>(1)</enum><text>Subsection (c) of section 223 of such Code is amended by striking paragraphs (2) and (3) and by redesignating paragraphs (4) and (5) as paragraphs (2) and (3), respectively.</text></paragraph> <paragraph id="idD09AF791ABA8437B96DE95466C6FE8B7"><enum>(2)</enum><text>Paragraphs (2)(A) and (2)(B) of section 223(b) of such Code are each amended by striking <quote>a high deductible health plan</quote> and inserting <quote>a health plan, insurance, or ministry described in subsection (c)(1)</quote>.</text></paragraph>
<paragraph id="idAB5676317BCF4AC5ADB393290955F87F"><enum>(3)</enum><text>Paragraph (8)(A)(ii) of section 223(b) of such Code is amended by striking <quote>high deductible health plan</quote> and inserting <quote>health plan, insurance, or ministry described in subsection (c)(1)</quote>.</text></paragraph> <paragraph id="id02DDCA3AD11F4E068CF0E3F89109A320"><enum>(4)</enum><text>Section 223(g)(1) of such Code is amended—</text>
<subparagraph id="id36C3478219B6448C87CA909D4FEA9867"><enum>(A)</enum><text>by striking <quote>subsections (b)(2) and (c)(2)(A)</quote> both places it appears and inserting <quote>subsection (b)(2)</quote>, and</text></subparagraph> <subparagraph id="id38470FC18B8F475182C48384D5C71B6D"><enum>(B)</enum><text>by striking <quote>for <quote>calendar year 2016</quote></quote> in subparagraph (B) and all that follows through <quote><quote>calendar year 2003</quote>.</quote> and inserting <quote><quote>calendar year 1997</quote> for <quote>calendar year 2016</quote> in subparagraph (A)(ii) thereof.</quote>.</text></subparagraph></paragraph>
<paragraph id="id8BD3E29C1EC04C54B6C6AC800399DA50"><enum>(5)</enum><text>The heading of subparagraph (B) of section 223(b)(8) of such Code is amended by striking <quote><header-in-text level="subparagraph" style="OLC">high deductible health plan</header-in-text></quote>.</text></paragraph> <paragraph id="id977E458D6D8048D698E5EC6E165C8D45"><enum>(6)</enum><text>Section 26(b)(2)(S) of such Code is amended by striking <quote>high deductible health plan</quote>.</text></paragraph>
<paragraph id="idFB2BFF7260D54FCE894110FBE8BD90FF"><enum>(7)</enum><text>The heading of paragraph (3) of section 106(e) of such Code is amended by striking <quote><header-in-text level="paragraph" style="OLC">high deductible health plan</header-in-text></quote>.</text></paragraph> <paragraph id="idBE19D028C76B4887AACF7A5E807EC5B3"><enum>(8)</enum><text>Clause (ii) of section 106(e)(5)(B) of such Code is amended by striking <quote>a high deductible health plan</quote> and inserting <quote>a health plan</quote>.</text></paragraph>
<paragraph id="id386FDD91A8F646B8BB27512727FAE9E7"><enum>(9)</enum><text>Paragraph (9) of section 408(d) of such Code is amended—</text> <subparagraph id="id8B79FC9EDB8648B9823159F9875CAE56"><enum>(A)</enum><text>by striking <quote>the high deductible health plan covering</quote> in subparagraph (C)(i)(I) and inserting <quote>health plan, insurance, or ministry of</quote>,</text></subparagraph>
<subparagraph id="idFEDF4CC8992742E897B57F113F1E9834"><enum>(B)</enum><text>by striking <quote>a high deductible health plan</quote> the first place it appears in subparagraph (C)(ii)(II) and inserting <quote>a health plan, insurance, or ministry described in section 223(c)(1)</quote>,</text></subparagraph> <subparagraph id="id5E195A0CB54043A9AE1EF0390682B3FC"><enum>(C)</enum><text>by striking <quote>a high deductible health plan</quote> the second place it appears in subparagraph (C)(ii)(II) and inserting <quote>any such plan, insurance, or ministry</quote>, and</text></subparagraph>
<subparagraph id="idFB7C84CC951D4C6A9D905DC50C88034E"><enum>(D)</enum><text>by striking <quote><header-in-text level="subparagraph" style="OLC">high deductible health plan</header-in-text></quote> in the heading of subparagraph (D).</text></subparagraph></paragraph></subsection> <subsection id="id1EF9C1E7B21B4E6BB5A60EE333808C9F"><enum>(c)</enum><header>Effective date</header><text>The amendments made by this section shall apply to taxable years beginning after December 31, 2020.</text></subsection></section>
<section id="idEF8F101BE93941B6A40CDFAE3695C655"><enum>3.</enum><header>Increase in HSA contribution limits</header>
<subsection id="id0956959CBBD6447F9486D324FBDC5930"><enum>(a)</enum><header>In general</header><text>Paragraph (2) of <external-xref legal-doc="usc" parsable-cite="usc/26/223">section 223(b)</external-xref> of the Internal Revenue Code of 1986 is amended—</text> <paragraph id="idF5F6E3F27FC54FBFBAD4509A4DD702DC"><enum>(1)</enum><text>by striking <quote>$2,250</quote> in subparagraph (A) and inserting <quote>$10,800</quote>, and</text></paragraph>
<paragraph id="id7DC2C891A24C4E30A95CA36B9155C485"><enum>(2)</enum><text>by striking <quote>$4,500</quote> in subparagraph (B) and inserting <quote>$29,500</quote>.</text></paragraph></subsection> <subsection id="id1B841D890915404EA830B435FD213B40"><enum>(b)</enum><header>Cost-of-Living adjustment</header><text>Paragraph (1) of <external-xref legal-doc="usc" parsable-cite="usc/26/223">section 223(g)</external-xref> of the Internal Revenue Code of 1986, as amended by section 2, is amended—</text>
<paragraph id="id010C3017D7AF4119A1F60C9F658672DB"><enum>(1)</enum><text>by striking <quote>Each</quote> and inserting <quote>In the case of a taxable year beginning after 2021, each</quote>, and</text></paragraph> <paragraph id="id50C8F679F930467D8DE1783AB51D1700"><enum>(2)</enum><text>by striking <quote>calendar year 1997</quote> and inserting <quote>calendar year 2020</quote>.</text></paragraph></subsection>
<subsection id="id7BC86AC4BDDD43D4B1C64B9D50FE33A1"><enum>(c)</enum><header>Effective date</header><text>The amendments made by this section shall apply to taxable years beginning after December 31, 2020.</text></subsection></section> <section id="idE08762F219BD41D39B76D744DFFE6EFA"><enum>4.</enum><header>Payment of health plan and health insurance premiums from HSA</header> <subsection id="idE827F475A5A44533BC0B876E2F38CE94"><enum>(a)</enum><header>In general</header><text>Paragraph (2) of <external-xref legal-doc="usc" parsable-cite="usc/26/223">section 223(d)</external-xref> of the Internal Revenue Code of 1986 is amended—</text>
<paragraph id="id0A9BB3AD84674F6DBADEDF54360DFF65"><enum>(1)</enum><text>by striking subparagraph (B),</text></paragraph> <paragraph id="id2FF818F31A3F4C7C9AE55A49A52E80DB"><enum>(2)</enum><text>by redesignating subparagraphs (C) and (D) as subparagraphs (B) and (C), respectively,</text></paragraph>
<paragraph id="id1080100A02024FAAAA96B073C7A9F51F"><enum>(3)</enum><text>by striking <quote>Subparagraph (B) shall not apply to any expense for coverage under</quote> in subparagraph (B), as so redesignated, and inserting <quote>Subparagraph (A) shall not apply to any payment for insurance other than</quote>, and</text></paragraph> <paragraph id="id24A5D3F051C249B599945D7E929C5F59"><enum>(4)</enum><text>in subparagraph (B), as so redesignated—</text>
<subparagraph id="id0BB94BAC6EB049DBA37281B6E76D371A"><enum>(A)</enum><text>by striking <quote>or</quote> at the end of clause (iii),</text></subparagraph> <subparagraph id="idD82A2EED26274784A9D64DB212AB8B15"><enum>(B)</enum><text>by striking the period at the end of clause (iv) and inserting <quote>, or</quote>, and</text></subparagraph>
<subparagraph id="id815B84AD6CFC496DBB9CA4DB13CB8195"><enum>(C)</enum><text>by adding at the end the following new clause:</text> <quoted-block style="OLC" display-inline="no-display-inline" id="id1630EFFAAD134D51840BAA9C142E09EA"> <clause id="id68E634E6FAE34F4FBFFC6720192E3D6B"><enum>(v)</enum><text>a health plan or health insurance coverage described in subsection (c)(1)(A).</text></clause><after-quoted-block>.</after-quoted-block></quoted-block></subparagraph></paragraph></subsection>
<subsection id="idF0F515B33E8E470AA209AD4267027315"><enum>(b)</enum><header>Effective date</header><text>The amendments made by this section shall apply to taxable years beginning after December 31, 2020.</text></subsection></section> <section id="id8f4f280c01264fc5a44f2a7713517029"><enum>5.</enum><header>Treatment of medical care service arrangements</header> <subsection id="idf3c676a0c7414dccb6ce577caec8f9be"><enum>(a)</enum><header>Inclusion as medical expenses</header><text>Paragraph (2) of <external-xref legal-doc="usc" parsable-cite="usc/26/223">section 223(d)</external-xref> of the Internal Revenue Code of 1986, as amended by section 4, is further amended by adding at the end the following new subparagraph:</text>
<quoted-block style="OLC" display-inline="no-display-inline" id="id0f77cc91cd0f48359f6396c79ec12c1e">
<subparagraph id="ida94eebfed2324f0baed6682110aeb788"><enum>(D)</enum><header>Inclusion of medical care service arrangements</header><text>The term <term>qualified medical expenses</term> shall include—</text> <clause id="idB2A19FF9B68E46D69B57F0D1D3BA95B1"><enum>(i)</enum><text>periodic fees paid to a physician for a defined set of medical services or for the right to receive medical services on an as-needed basis, and</text></clause>
<clause id="idccb99efea7e44ffca3c23d60baa4e434"><enum>(ii)</enum><text>amounts prepaid for medical services designed to screen for, diagnose, cure, mitigate, treat, or prevent disease and promote wellness.</text></clause></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block></subsection> <subsection id="id95BED4EC74034ACA88FD6CDA70B5EDA5"><enum>(b)</enum><header>Arrangement not To be treated as health insurance</header><text>Subsection (c) of <external-xref legal-doc="usc" parsable-cite="usc/26/223">section 223</external-xref> of the Internal Revenue Code of 1986, as amended by section 2(b), is further amended by adding at the end the following new paragraph:</text>
<quoted-block style="OLC" display-inline="no-display-inline" id="id0A61569B13C54C5D84445AD6DD37FFDD">
<paragraph id="idF76B22D1AEC344C68383A19966C59B63"><enum>(4)</enum><header>Treatment of medical care service arrangements</header><text>An arrangement under which an individual is provided medical services in exchange for a fixed periodic fee or payment for such services shall not be treated as a health plan, insurance, or arrangement described in paragraph (1).</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></subsection> <subsection id="iddcdafd52a0184d9ba22888a77dd4f7fa"><enum>(c)</enum><header>Effective date</header><text>The amendments made by this section shall apply to taxable years beginning after December 31, 2020.</text></subsection></section>
<section id="idB87EE9B4370541A1B86A42FFECBC8472"><enum>6.</enum><header>Periodic provider fees treated as medical care</header>
<subsection id="idCE4B2D513C26455A943247C07ABB755E"><enum>(a)</enum><header>In general</header><text><external-xref legal-doc="usc" parsable-cite="usc/26/213">Section 213(d)</external-xref> of the Internal Revenue Code of 1986 is amended by adding at the end the following new paragraph:</text> <quoted-block style="OLC" display-inline="no-display-inline" id="id561478C54F5543AC8CD87436FA065595"> <paragraph id="id8884B9CD2EB94CD7ACA286BFEDCB6D45"><enum>(12)</enum><header>Periodic provider fees</header><text>Periodic fees paid for a defined set of medical services provided on an as-needed basis shall be treated as amounts paid for medical care.</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></subsection>
<subsection id="idB5CDFA7846D84ECAB1D4BB386747CDDC"><enum>(b)</enum><header>Effective date</header><text>The amendment made by this section shall apply to taxable years beginning after December 31, 2020.</text></subsection></section> <section id="id20ba5a3a28e84371a71d875b4731fd7e"><enum>7.</enum><header>Restoring lower penalty for nonqualified distributions</header> <subsection id="id548fd4d2cfdd4b33ace779fded2c91b4"><enum>(a)</enum><header>In general</header><text><external-xref legal-doc="usc" parsable-cite="usc/26/223">Section 223(e)(4)(A)</external-xref> of the Internal Revenue Code of 1986 is amended by striking <quote>20 percent</quote> and inserting <quote>10 percent</quote>.</text></subsection>
<subsection id="idc8de7d6b9e3e4b1d8c0aa93033d3fd57"><enum>(b)</enum><header>Effective date</header><text>The amendments made by this section shall apply to distributions made in taxable years beginning after December 31, 2020.</text></subsection></section> <section id="id9BE5984236A046D0806A6C6868833B3A"><enum>8.</enum><header>Treatment of health care sharing ministries</header> <subsection id="id019B984E46C84E8F91744A94F49961AE"><enum>(a)</enum><header>Inclusion as medical expenses</header><text>Paragraph (2) of <external-xref legal-doc="usc" parsable-cite="usc/26/223">section 223(d)</external-xref> of the Internal Revenue Code of 1986, as amended by sections 4 and 5, is further amended by adding at the end the following new subparagraph:</text>
<quoted-block style="OLC" display-inline="no-display-inline" id="id58983C9C791B44A5910E467994F08A1B">
<subparagraph id="idEF9B146227D74103801B0F0E20C148DA"><enum>(E)</enum><header>Inclusion of health care sharing ministries</header><text>The term <term>qualified medical expenses</term> shall include amounts paid by a member of a health care sharing ministry (as defined in section 5000A(d)(2)(B)(ii)) for—</text> <clause id="id6E17D5BB7B9443A2B6C14AC3174CD130"><enum>(i)</enum><text>the sharing of medical expenses among members, and</text></clause>
<clause commented="no" display-inline="no-display-inline" id="idF0AB59F91C9E4F43ABEFEB74534710A1"><enum>(ii)</enum><text>administrative fees of the ministry.</text></clause></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block></subsection> <subsection id="id0EA34B7828BA4699BC5B4B2010E51519"><enum>(b)</enum><header>Health care sharing ministry not To be treated as health insurance</header><text>Subsection (c) of <external-xref legal-doc="usc" parsable-cite="usc/26/223">section 223</external-xref> of the Internal Revenue Code of 1986, as amended by sections 2 and 5, is further amended by adding at the end the following new paragraph:</text>
<quoted-block style="OLC" display-inline="no-display-inline" id="id2E3D3D7F54DE4F33A76BFE74BEC547B2">
<paragraph id="id499481A821204A579563A2DEE106BFFF"><enum>(5)</enum><header>Treatment of health care sharing ministries</header><text>A health care sharing ministry (as defined in section 5000A(d)(2)(B)(ii)) shall not be treated as a health plan or insurance for purposes of this title.</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></subsection> <subsection commented="no" display-inline="no-display-inline" id="id87E6A41B421649A891AE0BA24FE153C6"><enum>(c)</enum><header>Effective date</header><text>The amendments made by this section shall apply to taxable years beginning after December 31, 2020.</text></subsection></section>
</legis-body>
</bill> 


