Chronic Disease Flexible Coverage Act
The Chronic Disease Flexible Coverage Act would codify into statute the IRS guidance that designates certain services and items used for chronic conditions as preventive care for purposes of the high-deductible health plan (HDHP) safe harbor paired with health savings accounts (HSAs). Specifically, it makes the set of “additional preventive care services and items for chronic conditions” listed in IRS Notice 2019-45 legally treated as preventive care under section 223(c)(2)(C) of the Internal Revenue Code. In other words, those chronic-condition services would receive the same favorable treatment as other preventive care under HDHP/HSA rules, ensuring they are not counted toward the plan’s deductible (or otherwise treated as deductible-exempt) under the safe harbor. The bill also clarifies that no inference should be drawn about other guidelines or guidance from the Secretary beyond what is stated in the codified list. In short, the act would embed existing IRS guidance into law, strengthening and stabilizing coverage rules for preventive services related to chronic conditions within HDHP/HSA arrangements.
Key Points
- 1Codifies the chronic-condition preventive care services and items from IRS Notice 2019-45 into law.
- 2Those services/items will be treated as preventive care for purposes of the HDHP deductible safe harbor under 223(c)(2)(C) of the Internal Revenue Code.
- 3The codification makes the IRS guidance legally binding, as if the items were included in the statute.
- 4Includes a safety provision: no inferences should be drawn about other preventive-care rules or guidance not explicitly covered by this section.
- 5Status: Introduced in the 119th Congress, referred to the Senate Committee on Finance after passing the House (House passage noted March 4, 2025).