CNBC.COM
With open enrollment season in full swing, more Americans than ever will be able to fund tax-advantaged accounts aimed at health-care costs next year.
Embedded in the so-called "big beautiful" bill passed in July are three provisions that expand access to health savings accounts, accounts available to those enrolled in a high-deductible health insurance plan.
The changes are likely to attract 3 to 4 million new HSA participants in 2026, according to estimates from Morningstar.
Like a flexible spending account, an HSA is funded with pre-tax dollars and can be used to cover medical costs throughout the year. Unlike an FSA, the money doesn't have a "use it or lose it" provision. Rather, the funds sit in an account you own and can take with you should you switch jobs.
Another feature that sets HSAs apart: You can invest the money in the likes of stocks, bonds or exchange-traded funds. And if you invest the money rather than spending it on pressing health-care needs, that's where some serious advantages kick in, experts say.
"An HSA is indeed one of the most powerful, yet underutilized, financial tools available, especially considering its unique triple tax advantage — contributions are tax-deductible, growth is tax-free and withdrawals for qualified medical expenses are also tax-free," Sean Lovison, a certified financial planner and founder of Purpose Built Financial Services, previously told CNBC Make It.
HSAs are expanding to three groups of people
Generally, to qualify for an HSA, you have to be enrolled in a high-deductible plan. For 2026, that means one with a deductible of at least $1,700 for individuals or $3,400 for families. You can't have any disqualifying health-care coverage, be enrolled in Medicare or be claimed as a dependent on someone else's tax return, among other requirements.
Under the new bill, three groups of people are now eligible for an HSA for whom rules had previously been either murky or prohibitive.
1. Everyone enrolled in bronze and catastrophic plans
Insurance plans available on the Affordable Care Act marketplace generally fall into one of five categories: platinum, gold, silver, bronze and catastrophic. Generally, platinum plans have higher premiums and lower deductibles, and bronze and catastrophic plans (the latter are only available to people under 30 and some people with limited incomes) have lower premiums and higher deductibles.
Until recently, enrollees in these plans were HSA-eligible on a case-by-case basis. The new bill makes anyone covered under a bronze or catastrophic plan eligible for an HSA.
While catastrophic plans aren't widely used, about 7.2 million Americans are currently covered under bronze plans, according to the Centers for Medicare and Medicaid Services.
2. People who use direct primary care services
Under the new law, people enrolled in direct primary care services are eligible for an HSA, provided that their coverage meets the other HDHP requirements.
Under the DPC model, offered through providers such as One Medical, patients pay a recurring fee for a series of services that don't get billed to insurance — a convention that put it in a legal gray area when it came to HSA eligibility.
"This is really more clearing up an ambiguity issue rather than something that's going to be a paradigm shift for folks," says Jake Spiegel, senior research associate at the Employee Benefits Research Institute. "What the bill says is, you can do this and still contribute to an HSA, and that's totally OK."
3. Some people who use telehealth
Under pandemic-era legislation, including the CARES Act, high-deductible plans could waive the deductible on telehealth services — regardless of whether they were preventative — and still qualify for HSA eligibility.
Those rules lapsed at the end of 2024, but the new bill reinstated them and made them permanent.
That doesn't mean that high-deductible plans must offer telehealth services for enrollees to be eligible for an HSA. Rather, such plans cannot be excluded simply because they allow participants to receive telehealth without contributing toward the deductible.
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