[Congressional Record Volume 164, Number 124 (Tuesday, July 24, 2018)]
[House]
[Pages H7109-H7110]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




             NATIVE AMERICAN HEALTH SAVINGS IMPROVEMENT ACT

  Mr. ROSKAM. Mr. Speaker, I move to suspend the rules and pass the 
bill (H.R. 1476) to amend the Internal Revenue Code of 1986 to permit 
individuals eligible for Indian Health Service assistance to qualify 
for health savings accounts, as amended.
  The Clerk read the title of the bill.
  The text of the bill is as follows:

                               H.R. 1476

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

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Native American Health 
     Savings Improvement Act''.

     SEC. 2. INDIVIDUALS ELIGIBLE FOR INDIAN HEALTH SERVICE 
                   ASSISTANCE NOT DISQUALIFIED FROM HEALTH SAVINGS 
                   ACCOUNTS.

       (a) In General.--Section 223(c)(1) of the Internal Revenue 
     Code of 1986 is amended by adding at the end the following 
     new subparagraph:
       ``(D) Special rule for individuals eligible for assistance 
     under indian health service programs.--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 hospital care or 
     medical services under a medical care program of the Indian 
     Health Service or of a tribal organization.''.
       (b) Effective Date.--The amendment made by this section 
     shall apply to taxable years beginning after December 31, 
     2018.

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from 
Illinois (Mr. Roskam) and the gentleman from California (Mr. Thompson) 
each will control 20 minutes.

[[Page H7110]]

  The Chair recognizes the gentleman from Illinois.


                             General Leave

  Mr. ROSKAM. Mr. Speaker, I ask unanimous consent that all Members may 
have 5 legislative days within which to revise and extend their remarks 
and include extraneous material on H.R. 1476, currently under 
consideration.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Illinois?
  There was no objection.
  Mr. ROSKAM. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, I am happy to stand before you today as we consider H.R. 
1476, the Native American Health Savings Improvement Act, a bipartisan 
bill introduced by Mr. Moolenaar of Michigan, that makes commonsense 
improvements to current rules surrounding health savings accounts and 
those who get care through the Indian Health Service.
  Generally, anyone covered solely by a high-deductible health plan 
that meets certain requirements is allowed to make tax-free 
contributions to a health savings account. But for certain individuals 
who receive care through the Indian Health Service, this isn't the 
case.
  Under IRS guidance, an individual who has received medical services 
at an Indian Health Service facility at any time during the previous 3 
months is ineligible to make contributions to an HSA. This practice 
could discourage those who rely on care delivered at an Indian Health 
Service facility from participating in an HSA. This should be fixed so 
that these enrollees can avail themselves to the benefits of Health 
Savings Accounts.
  High-deductible health plans and health savings accounts are critical 
components of consumer-driven healthcare. Together, they empower 
individuals and families to shop around. They unleash the power of 
choice and competition that are so badly needed in healthcare to lower 
costs and improve quality today. These are the elements we need to 
encourage in the system, if we are going to start bending the cost 
curve in the right direction, and if we want to lower barriers to these 
types of accounts and encourage individuals who are otherwise eligible 
not to forgo treatment at an Indian Health Service facility simply 
because of confusion over when they might be able to resume 
contributing to their HSA.
  I urge my colleagues to join me in supporting this bipartisan 
legislation, and I reserve the balance of my time.
  Mr. THOMPSON of California. Mr. Speaker, I yield myself such time as 
I may consume.
  Mr. Speaker, the House has passed this bill before. It allows 
individuals eligible for Indian Health Service, or IHS, to participate 
in a health savings account if they are enrolled in a high-deductible 
health plan.
  I support this bill. We should be talking about issues in healthcare 
that strengthen our healthcare system for all Americans while 
addressing the issues in the Indian Health Service program, and there 
should be no exception to that today.
  Given the important role IHS plays providing primary care to our 
Native American population, we should be working to ensure that all 
participants in IHS have access to high-quality care. Reports of 
underfunding and resulting substandard care need to be addressed, so we 
make sure that all individuals that this healthcare program serves 
benefit from the congressional action that we take, not just those who 
happen to have the money to put in an HSA, to pay for an HSA.
  We shouldn't overlook the important role Medicare and Medicaid play 
in providing healthcare to these populations. Thousands of IHS 
beneficiaries are also enrolled in Medicare, Medicaid, or some 
combination of both.
  Republicans are looking to dramatically cut and undermine these 
critical programs. Offering IHS enrollees a savings account won't make 
up for damage inflicted by the cuts to Medicaid or Medicare.
  Instead, we should strengthen both of these programs and coordinate 
care with IHS to make sure individuals are getting the best care 
possible.
  I reserve the balance of my time.
  Mr. ROSKAM. Mr. Speaker, I yield 5 minutes to the gentleman from 
Michigan (Mr. Moolenaar).
  Mr. MOOLENAAR. Mr. Speaker, first, I want to thank Chairman Brady of 
the House Committee on Ways and Means for his leadership of the 
committee, and also Mr. Roskam and Mr. Thompson for their support here 
on the floor today.
  I also want to thank Congressman Raul Ruiz for cosponsoring this 
legislation and making it bipartisan.
  This legislation before us today, H.R. 1476, will improve access to 
health savings accounts for Native Americans who choose to receive care 
at Indian Health Service facilities by ending an unnecessary penalty 
against them.
  Mr. Speaker, if you or I were to use a health savings account, we 
would be able to immediately make a contribution to it the day after 
you receive care at a doctor's office. There is no prohibition on 
making those contributions.
  However, right now, Native Americans across the country, including my 
constituents, cannot do the same thing if they receive treatment from a 
doctor at the Indian Health Service. Instead, they are prohibited from 
immediately saving the money they earned and must wait for 3 months 
before they can make another contribution into the personal account 
they use to provide for their health and that of their family.
  This makes no sense. Instead, this commonsense legislation eliminates 
the problem. If this bill becomes law, Native Americans will no longer 
have to wait 3 months. They will be able to receive treatment from 
Indian Health Service doctors near them and save money in their HSAs 
whenever they want.
  This is a bipartisan, patient-centered solution to a government-
created problem.

                              {time}  1500

  It will benefit the Saginaw Chippewas in my district as well as 
Tribes throughout Michigan and across the country. It will help those 
who work hard to save money and take care of their families.
  Mr. Speaker, I thank my colleagues for their support of this 
legislation.
  Mr. THOMPSON of California. Mr. Speaker, I yield myself the balance 
of my time.
  Mr. Speaker, I thank the sponsors of this bill, and I want to give a 
particular shout-out to Congressman Raul Ruiz, also Dr. Ruiz when he is 
not in Congress, for his cosponsorship of this bill and all the hard 
work that he has put into this effort.
  Mr. Speaker, I urge my colleagues on both sides of the aisle to cast 
an ``aye'' vote for this measure, and I yield back the balance of my 
time.
  Mr. ROSKAM. Mr. Speaker, about 22 million Americans are covered by 
high-deductible health plans with an HSA. These are options that are 
increasingly popular across the spectrum because they lower premiums 
and they are a vehicle to save for other healthcare expenses.
  I think this is a good bill. It has been well articulated this 
afternoon, particularly by the bill's sponsor and by Mr. Thompson, and 
I urge its passage.
  Mr. Speaker, I yield back the balance of my time.
  The SPEAKER pro tempore (Mr. Johnson of Louisiana). The question is 
on the motion offered by the gentleman from Illinois (Mr. Roskam) that 
the House suspend the rules and pass the bill, H.R. 1476, as amended.
  The question was taken; and (two-thirds being in the affirmative) the 
rules were suspended and the bill, as amended, was passed.
  A motion to reconsider was laid on the table.

                          ____________________