HR 6183119th CongressIn Committee

To amend the Internal Revenue Code of 1986 to reform certain rules related to health savings accounts.

Introduced: Nov 20, 2025

Sponsor: Rep. Doggett, Lloyd [D-TX-37] (D-Texas)

Standard Summary

Comprehensive overview in 1-2 paragraphs

H.R. 6183 amends the Internal Revenue Code to overhaul health savings account (HSA) rules, including eliminating the penalty‑free distribution exception for non‑qualified medical expenses, imposing income‑based contribution limits, tightening substantiation requirements for distributions, limiting reimbursements to two years, excluding certain non‑medical expenses, imposing excise taxes on excessive HSA fees, and enhancing reporting of cash balance earnings.

Key Points

1Repeals the exception that allows penalty‑free HSA distributions for non‑qualified medical expenses.
2Introduces a modified adjusted gross income‑based deduction limitation for HSA contributions.
3Adds a substantiation requirement for all HSA distributions used for qualified medical expenses.
4Limits HSA reimbursements to a two‑year period after the expense was paid.
5Excludes spa, beauty treatments, and exercise equipment over $500 from being treated as medical care.
6Imposes an excise tax on excessive HSA fees and requires trustees to report fee information.

Impact Areas

Health savings account holders and beneficiariesEmployers offering HSAsHSA trustees and financial institutionsTaxpayers with high income levelsHealthcare providers and insurers

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