119 S3362 IS: Health Marketplace and Savings Accounts for All Act
U.S. Senate
2025-12-04
text/xml
EN
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.
II
119th CONGRESS
1st Session
S. 3362
IN THE SENATE OF THE UNITED STATES
December 4, 2025
Mr. Paul introduced the following bill; which was read twice and referred to the Committee on Finance
A BILL
To amend the Internal Revenue Code of 1986 to increase the limitations on contributions to health savings accounts, and for other purposes.
1.

Short title; table of contents
(a)

Short title
This Act may be cited as the “Health Marketplace and Savings Accounts for All Act”.
(b)

Table of contents
The table of contents for this Act is as follows:
Sec. 1. Short title; table of contents.
TITLE I—Health Savings Accounts
Sec. 101. Short title.
Sec. 102. Increase in contribution limitations.
Sec. 103. Freedom from mandate.
Sec. 104. Amounts paid for health insurance or direct primary care service arrangement.
Sec. 105. Special rule for certain medical expenses incurred before establishment of account.
Sec. 106. Administrative error correction before due date of return.
Sec. 107. Allowing HSA rollover to child or parent of account holder.
Sec. 108. Coverage for amounts paid for vitamins, dietary supplements, gym memberships, and wearable fitness trackers.
Sec. 109. Equivalent bankruptcy protections for health savings accounts as retirement funds.
TITLE II—Health Marketplace for All
Sec. 201. Short title.
Sec. 202. Health marketplace pools deemed an “employer” for purposes of offering group health plans or group health insurance coverage.
Sec. 203. Conforming amendments.
I

Health Savings Accounts
101.

Short title
This title may be cited as the “Health Savings Accounts For All Act of 2025”.
102.

Increase in contribution limitations
(a)

In general
Subsection (b) of section 223 of the Internal Revenue Code of 1986 is amended—
(1)
in paragraph (1), by striking “the sum of” and all that follows through the period and inserting “an amount equal to the applicable dollar amount under paragraph (1)(B) of section 402(g) (as adjusted pursuant to paragraph (4) of such section) with respect to such taxable year.”,
(2)
by striking paragraphs (2), (3), (5), (7), and (8),
(3)
by inserting after paragraph (1) the following:
“(2)

Additional contributions for individuals 50 or older
In the case of an individual who has attained age 50 before the close of the taxable year, the amount of the limitation under paragraph (1) shall be increased by an amount equal to the applicable dollar amount under subparagraph (B)(i) of section 414(v)(2) (as adjusted pursuant to subparagraph (C) of such section).”,
(4)
in paragraph (4), by striking the flush matter following subparagraph (C), and
(5)
by redesignating paragraphs (4) and (6) as paragraphs (3) and (4), respectively.
(b)

Conforming amendments
(1)
Subparagraph (A) of section 223(d)(1) of the Internal Revenue Code of 1986 is amended by striking “the sum of—” and all that follows through the period and inserting “the amount determined under subsection (b)(1).”.
(2)
Subsection (g)(1) of section 223 of such Code is amended—
(A)
by striking “(b)(2), (c)(2)(A), and” and inserting “(c)(2)(A) and,”,
(B)
by amending subparagraph (B) to read as follows:
“(B)
the cost-of-living adjustment determined under section 1(f)(3) for the calendar year in which such taxable year begins determined by substituting “calendar year 2003” for “calendar year 2016” in subparagraph (A)(ii) thereof.”, and
(C)
by striking “(b)(2), (c)(1)(E)(ii)(II),” and inserting “(c)(1)(E)(ii)(II)”.
(3)
Section 26(b)(2)(S) of such Code is amended by striking “, 223(b)(8)(B)(i)(II),”.
(4)
Section 408(d)(9)(C)(i)(I) of such Code is amended by striking “computed on the basis of the type of coverage under the high deductible health plan covering the individual”.
(c)

Effective date
The amendments made by this section shall apply to taxable years beginning after the date of the enactment of this Act.
103.

Freedom from mandate
(a)

In general
Section 223 of the Internal Revenue Code of 1986, as amended by section 102, is further amended by striking subsections (c) and (g) and by redesignating subsections (d), (e), (f), and (h) as subsections (c), (d), (e), and (f), respectively.
(b)

Conforming amendments
(1)
Subsection (a) of section 223 of the Internal Revenue Code of 1986 is amended to read as follows:
“(a)

Deduction allowed
In the case of an individual, there shall be allowed as a deduction for the taxable year an amount equal to the aggregate amount paid in cash during such taxable year by or on behalf of such individual to a health savings account of such individual.”.
(2)
Subsection (c)(1)(A) of section 223 of such Code, as amended by section 102 and redesignated by subsection (a), is further amended by striking “subsection (f)(4)” and inserting “subsection (e)(4)”.
(3)
Subparagraph (U) of section 26(b)(2) of such Code, as amended by section 102, is further amended by striking “section 223(f)(3)” and inserting “section 223(e)(3)”.
(4)
Sections 35(g)(3), 220(f)(5)(A), 848(e)(1)(B)(v), 4973(a)(5), and 6051(a)(12) of such Code are each amended by striking “section 223(d)” each place it appears and inserting “section 223(c)”.
(5)
Section 106(d)(1) of such Code is amended—
(A)
by striking “who is an eligible individual (as defined in section 223(c)(1))”, and
(B)
by striking “section 223(d)” and inserting “section 223(c)”.
(6)
Section 106(e) of such Code is amended—
(A)
by striking paragraphs (3) and (4) and by redesignating paragraph (5) as paragraph (4),
(B)
by inserting after paragraph (2) the following new paragraph:
“(3)

Treatment as rollover contribution
A qualified HSA distribution shall be treated as a rollover contribution described in section 223(e)(4).”, and
(C)
by striking “to any eligible individual covered under a high deductible health plan of the employer” in paragraph (4)(B)(ii) (as so redesignated) and inserting “to any employee with respect to whom a health savings account has been established”.
(7)
Section 408(d)(9)(A) of such Code is amended by striking “who is an eligible individual (as defined in section 223(c)) and”.
(8)
Section 877A(g)(6) of such Code is amended by striking “223(f)(4)” and inserting “223(e)(4)”.
(9)
Section 4973(g) of such Code is amended—
(A)
by striking “section 223(d)” and inserting “section 223(c)”,
(B)
in paragraph (1), by striking “or 223(f)(5)” and inserting “or 223(e)(5)”,
(C)
in paragraph (2)(A), by striking “section 223(f)(2)” and inserting “section 223(e)(2)”, and
(D)
in the flush matter at the end, by striking “section 223(f)(3)” and inserting “section 223(e)(3)”.
(10)
Section 4975 of such Code is amended—
(A)
in subsection (c)(6)—
(i)
by striking “section 223(d)” and inserting “section 223(c)”, and
(ii)
by striking “section 223(e)(2)” and inserting “section 223(d)(2)”, and
(B)
in subsection (e)(1)(E), by striking “section 223(d)” and inserting “section 223(c)”.
(11)
Subsection (b) of section 4980G of such Code is amended to read as follows:
“(b)

Rules and requirements
(1)

In general
An employer meets the requirements of this subsection for any calendar year if the employer makes available comparable contributions to the health savings accounts of all comparable participating employees for each coverage period during such calendar year.
(2)

Comparable contributions
(A)

In general
For purposes of paragraph (1), the term comparable contributions means contributions—
(i)
which are the same amount, or
(ii)
if the employees are covered by a health plan, which are the same percentage of the annual deductible limit under the plan covering the employees.
(B)

Part-year employees
In the case of an employee who is employed by the employer for only a portion of the calendar year, a contribution to the health savings account of such employee shall be treated as comparable if it is an amount which bears the same ratio to the comparable amount (determined without regard to this subparagraph) as such portion bears to the entire calendar year.
(3)

Comparable participating employees
For purposes of paragraph (1), the term comparable participating employees means all employees who are covered (if at all) under the same health plan of the employer and have the same category of coverage. For purposes of the preceding sentence, the categories of coverage are self-only and family coverage.
(4)

Part-time employees
(A)

In general
Paragraph (3) shall be applied separately with respect to part-time employees and other employees.
(B)

Part-time employee
For purposes of subparagraph (A), the term part-time employee means any employee who is customarily employed for fewer than 30 hours per week.”.
(12)
Section 4980G(d) of such Code is amended by striking “section 4980E” and inserting “this section”.
(13)
Section 6693(a)(2)(C) of such Code is amended by striking “section 223(h)” and inserting “section 223(f)”.
(c)

Effective date
The amendments made by this section shall apply to taxable years beginning after the date of the enactment of this Act.
104.

Amounts paid for health insurance or direct primary care service arrangement
(a)

In general
Paragraph (2) of section 223(c) of the Internal Revenue Code of 1986, as redesignated by section 3, is amended—
(1)
in subparagraph (A), by inserting “or pursuant to an arrangement under which an individual is provided coverage restricted to primary care services in exchange for a fixed periodic fee or payment for primary care services” after “menstrual care products”,
(2)
by striking subparagraphs (B) and (C), and
(3)
by redesignating subparagraph (D) as subparagraph (B).
(b)

Conforming amendment
Paragraph (2) of section 223(c) of the Internal Revenue Code of 1986, as amended by the preceding sections of this Act, is further amended by striking “and any dependent (as defined in section 152, determined without regard to subsections (b)(1), (b)(2), and (d)(1)(B) thereof) of such individual” and inserting “any dependent (as defined in section 152, determined without regard to subsections (b)(1), (b)(2), and (d)(1)(B) thereof) of such individual, and any child (as defined in section 152(f)(1)) of such individual who has not attained the age of 27 before the end of such individual's taxable year”.
(c)

Technical amendments
(1)
Section 220(d)(2)(A) of the Internal Revenue Code of 1986 is amended by striking “section 223(d)(2)(D)” and inserting “section 223(c)(2)(B)”.
(2)
Subsection (f) of section 106 of the Internal Revenue Code of 1986 is amended by striking “section 223(d)(2)(D)” and inserting “section 223(c)(2)(B)”.
(d)

Effective dates
(1)

In general
The amendments made by subsections (a) and (b) shall apply with respect to amounts paid after the date of the enactment of this Act in taxable years beginning after such date.
(2)

Technical amendments
The amendments made by subsection (c) shall apply with respect to taxable years beginning after the date of enactment of this Act.
105.

Special rule for certain medical expenses incurred before establishment of account
(a)

In general
Paragraph (2) of section 223(c) of the Internal Revenue Code of 1986, as amended and redesignated by the preceding sections of this Act, is further amended by adding at the end the following new subparagraph:
“(C)

Certain medical expenses incurred before establishment of account treated as qualified
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—
(i)
during either—
(I)
the taxable year in which the health savings account was established, or
(II)
the preceding taxable year, in the case of a health savings account established after the taxable year in which such expense was incurred but before the time prescribed by law for filing the return for such taxable year (not including extensions thereof), and
(ii)
for medical care which (but for the fact that it was incurred before the establishment of the account) otherwise meets the requirements of the preceding subparagraphs.”.
(b)

Effective date
The amendment made by this section shall apply to taxable years beginning after the date of the enactment of this Act.
106.

Administrative error correction before due date of return
(a)

In general
Paragraph (4) of section 223(e) of the Internal Revenue Code of 1986, as amended and redesignated by the preceding sections of this Act, is amended by adding at the end the following new subparagraph:
“(D)

Exception for administrative errors corrected before due date of return
Subparagraph (A) shall not apply if any payment or distribution is made to correct an administrative, clerical, or payroll contribution error and if—
(i)
such distribution is received by the individual on or before the last day prescribed by law (including extensions of time) for filing such individual's return for such taxable year, and
(ii)
such distribution is accompanied by the amount of net income attributable to such contribution.
Any net income described in clause (ii) shall be included in the gross income of the individual for the taxable year in which it is received.”.
(b)

Effective date
The amendment made by this section shall take effect on the date of the enactment of this Act.
107.

Allowing HSA rollover to child or parent of account holder
(a)

In general
Paragraph (8)(A) of section 223(e) of the Internal Revenue Code of 1986, as redesignated by the preceding sections of this Act, is amended—
(1)
by inserting “, child, parent, or grandparent” after “surviving spouse”,
(2)
by inserting “, child, parent, or grandparent, as the case may be,” after “the spouse”,
(3)
by inserting “, child, parent, or grandparent” after “spouse” in the heading thereof, and
(4)
by adding at the end the following: “In the case of a child who acquires such beneficiary’s interest and 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 individual’s taxable year begins, such health savings account shall be treated as a health savings account of such child.”.
(b)

Effective date
The amendments made by this section shall apply to taxable years beginning after the date of the enactment of this Act.
108.

Coverage for amounts paid for vitamins, dietary supplements, gym memberships, and wearable fitness trackers
(a)

In general
Paragraph (2) of section 223(c) of the Internal Revenue Code of 1986, as amended by the preceding provisions of this Act, is amended—
(1)
in subparagraph (A), by inserting “, qualified wellness expenses,” after “menstrual care products”, and
(2)
by adding at the end the following:
“(C)

Qualified wellness expenses
For purposes of this paragraph, the term qualified wellness expenses means amounts paid for—
(i)
vitamins,
(ii)
dietary supplements (as defined in section 201(ff) of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 321(ff))),
(iii)
membership at a gym or fitness facility, or
(iv)
wearable fitness trackers.”.
(b)

Effective date
The amendments made by this section shall apply to taxable years beginning after the date of the enactment of this Act.
109.

Equivalent bankruptcy protections for health savings accounts as retirement funds
(a)

In general
Section 522 of title 11, United States Code, is amended by adding at the end the following new subsection:
“(r)

Treatment of health savings accounts
For purposes of this section, any health savings account (as described in section 223 of the Internal Revenue Code of 1986) shall be treated in the same manner as an individual retirement account described in section 408 of such Code.”.
(b)

Effective date
The amendment made by this section shall apply to cases commencing under title 11, United States Code, after the date of the enactment of this Act.
II

Health Marketplace for All
201.

Short title
This title may be cited as the “Health Marketplace for All Act of 2025”.
202.

Health marketplace pools deemed an “employer” for purposes of offering group health plans or group health insurance coverage
(a)

Definition of employer
Section 3(5) of the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1002(5)) is amended by adding at the end the following: “Such term shall be deemed to include, for purposes of offering a group health plan (as defined in section 733(a)(1)) or group health insurance coverage (as defined in section 733(b)(4)) (which, notwithstanding any other provision of law, may include such a plan or coverage covering prescription or nonprescription drugs as the only benefit offered by the plan or coverage in accordance with section 736(b)(5)(B)), any entity that meets the requirements under section 736(b).”.
(b)

Group health plans and group health insurance coverage
Part 7 of subtitle B of title I of the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1181 et seq.) is amended by adding at the end the following:
“736.

Health marketplace pools deemed an “employer” for purposes of offering group health plans or group health insurance coverage
(a)

In general
An entity (referred to in this section as a “health marketplace pool”) that meets the requirements under subsection (b) shall be deemed an employer under section 3(5) for purposes of offering a group health plan or group health insurance coverage (which, notwithstanding any other provision of law, may include such a plan or coverage covering prescription or nonprescription drugs as the only benefit offered by the plan or coverage in accordance with subsection (b)(5)(B)).
(b)

Requirements for health marketplace pools
The requirements under this subsection are each of the following:
(1)

Organization
The health marketplace pool shall—
(A)
be formed and maintained in good faith for a purpose that includes the formation of a risk pool in order to offer group health insurance coverage or a group health plan to its members; and
(B)
not condition membership in the health marketplace pool on any health status-related factor relating to an individual (including an employee of an employer or a dependent of an employee).
(2)

Offering group health plans and group health insurance coverage
(A)

Different groups
(i)

In general
The health marketplace pool, which may be in conjunction with a health insurance issuer that offers group health insurance coverage through the health marketplace pool, shall make available a group health plan or group health insurance coverage to all members of the health marketplace pool (and, in the case of members that are employers, employees of the employers) at rates that—
(I)
are established by the health marketplace pool, or a health insurance issuer contracting with such health marketplace pool, on a policy or product specific basis; and
(II)
subject to sections 701 and 702, may vary for individuals covered through the health marketplace pool.
(ii)

Permissible coverage for dependents
Such group health plan or group health insurance coverage may be made available under clause (i) to any dependents of members of the health marketplace pool or dependents of employees of employers that are such members.
(B)

Nondiscrimination in coverage offered
(i)

In general
Subject to clause (ii), the health marketplace pool may not offer coverage under a group health plan or group health insurance coverage to a member of the health marketplace pool unless the same coverage is offered to all such members of the health marketplace pool.
(ii)

Construction
Nothing in this subsection shall be construed as requiring a health insurance issuer or group health plan to provide coverage outside the service area of the issuer or plan, or preventing a health insurance issuer or group health plan from underwriting or from excluding or limiting the coverage on any individual, subject to the requirements under sections 701 and 702.
(C)

Assumption of risk
The health marketplace pool may provide—
(i)
group health insurance coverage through a contract with a health insurance issuer; or
(ii)
a group health plan through self-insurance.
(3)

Geographic areas
Nothing in this subsection shall be construed as preventing the establishment and operation of more than 1 health marketplace pool in a geographic area or as limiting the number of health marketplace pools that may operate in any area.
(4)

Provision of administrative services to purchasers
The health marketplace pool may provide administrative services for members. Such services may include accounting, billing, and enrollment information.
(5)

Drug coverage
The group health plan or group health insurance coverage offered by the health marketplace pool may offer—
(A)
drug coverage, including coverage of over-the-counter drugs, in combination with other benefits covered by the group health plan or group health insurance coverage; or
(B)
notwithstanding any other provision of law, drug coverage, including coverage of over-the-counter drugs, as the only benefit covered by the group health plan or group health insurance coverage.
(6)

Members
(A)

In general
With respect to an individual who is a member of the health marketplace pool—
(i)
the individual may enroll for coverage under the group health plan or group health insurance coverage offered by the health marketplace pool (including, if applicable, enrollment for coverage for a dependent of such individual); or
(ii)
the employer of the individual may enroll the individual for coverage under the group health plan or group health insurance coverage offered by the health marketplace pool (including, if applicable, enrollment for coverage for a dependent of such individual).
(B)

Eligibility
An individual shall be eligible to be a member of the health marketplace pool if such individual is—
(i)
a member of an entity that establishes or joins the health marketplace pool (or a dependent of such a member, as applicable);
(ii)
an employee of a member of an entity described in clause (i) (or a dependent of such an employee, as applicable); or
(iii)
an employee of an entity (or a dependant of such an employee, as applicable) controlled by a member of an entity described in clause (i).
(C)

Rules for enrollment
Nothing in this paragraph shall preclude the health marketplace pool from establishing rules of enrollment and reenrollment of members. Such rules shall be applied consistently to all members within the health marketplace pool and shall not be based in any manner on health status-related factors in accordance with sections 701 and 702.
(c)

Determination of employer and joint employer status
Participating in or facilitating a group health plan or group health insurance coverage under this section shall not be construed as establishing under any Federal or State law—
(1)
an employer relationship for any purpose other than offering the group health plan or group health insurance coverage; or
(2)
a joint employer relationship for any purpose.
(d)

Definition
In this section, the term dependent, as applied to a group health plan or group health insurance coverage offered in a State, shall have the meaning applied to such term with respect to such plan or coverage under the State law applying to such plan or coverage. Such term may include the spouse and children of the individual involved in accordance with such State law.”.
203.

Conforming amendments
Section 3 of the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1002) is amended—
(1)
in paragraph (6), by inserting before the period “, except (with respect to an entity meeting the requirements under section 736(b)) such term includes any member of such entity”;
(2)
in paragraph (21)—
(A)
in subparagraph (A), by striking “subparagraph (B)” and inserting “subparagraphs (B) and (C)”; and
(B)
by adding at the end the following:
“(C)
With respect to a person that is a member of an entity (referred to in section 736 and this subparagraph as a “health marketplace pool”) that meets the requirements of section 736(b) and offers a group health plan (as defined in section 733(a)(1)) or group health insurance coverage (as defined in section 733(b)(4)) (which, notwithstanding any other provision of law, may include such a plan or coverage covering prescription or nonprescription drugs as the only benefit offered by the plan or coverage), membership in the health marketplace pool shall not by itself cause the person to be a fiduciary with respect to the group health plan or group health insurance coverage.”; and
(3)
in paragraph (40)(A)—
(A)
in clause (ii), by striking “, or” and inserting “,”;
(B)
in clause (iii), by striking the period and inserting “, or”; and
(C)
by adding at the end the following:
“(iv)
as a group health plan (as defined in section 733(a)(1)), or group health insurance coverage (as defined in section 733(b)(4)), offered by an entity meeting the requirements under section 736(b) (which, notwithstanding any other provision of law, may include such an entity offering such a plan or coverage covering prescription or nonprescription drugs as the only benefit offered by the plan or coverage).”.