Health savings accounts (HSAs) are getting a checkup under a new tax-and-spending bill. The legislation — which the House of Representatives passed on May 22 — includes changes to HSAs which would expand access to an additional 20 million people if signed into law. Currently, at least 60 million Americans have access to the tax-advantaged accounts via eligible high-deductible health insurance plans (HDHP).¹

The move would be the biggest expansion of HSAs since they first became available in 2004.² Those with access to a HSA could see their contribution limits double (depending on income), gym memberships added to the list of eligible expenses, and new benefits for spouses.³ Together, the 10 HSA-related provisions are projected to cost $44.3 billion over 10 years, according to the Congressional Budget Office.⁴

An asset for health and wealth

Almost one quarter of Americans say contributions to HSAs are the workplace financial benefit they value most, according to Empower research.

Over the past two decades, HSAs have become a part of a widely available health-coverage option, both for employees and individual buyers. The accounts come with a triple tax advantage: Tax-deductible contributions, tax-free growth, and tax-free withdrawals for qualified medical expenses. Plus, there’s the secondary benefit of helping to build long-term savings for retirement.

Read more: Turning HSAs into retirement tools

Well-loved and utilized, HSAs are particularly popular among younger generations and those who have lower medical expenses, given there is no use-it-or-lose it policy: Any unused money at the end of the year is carried over to the next year.⁵ In 2024, Americans held $146.6 billion in HSA accounts – that’s more than double the $69.5 billion total assets held in 2019.⁶

How HSAs could change under the new bill

If passed as currently written, the 10 provisions expanding HSA benefits would take effect for 2026. Of those provisions, some key updates include:⁷

Increased contribution limits

For 2025, the maximum tax-deductible HSA contribution is $8,550 for a family and $4,300 for single coverage, plus an additional $1,000 for participants age 55 and older.⁸ The new provisions would allow individuals who make less than $75,000 per year to contribute an additional $4,300 yearly into their HSA, indexed for inflation. For families, the provision allows households making up to $150,000 per year to contribute an additional $8,550.

Expansion of eligible expenses

The proposal would also allow HSA distributions to be used for certain sports and fitness expenses, including gym membership and participation/instruction in physical activities — the costliest provision of the bill. Annual HSA distributions for these expenses would be capped at $500 for single taxpayers and $1,000 for joint or head of household filers.

Eligibility for Medicare Part A recipients

Individuals age 65 or older and enrolled only in Medicare Part A would be allowed to make HSA contributions, which is prohibited by current law.

Treating Marketplace bronze and catastrophic plans as a HDHP

To increase accessibility of HSAs in the individual market, bronze plans and catastrophic plans would be treated as HDHPs that can be paired with an HSA.

Catch-up contributions for spouses to the same account 

Under current law, spouses are eligible to make a $1,000 catch-up contribution annually at age 55 and beyond — but only to their own HSA. The new provision would enable both spouses to make their catch-up contributions to the same HSA, which could be beneficial if only one spouse has access to an HSA.

Read more: What can I use my HSA account for?

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The bill is subject to change as it makes its way through the legislative process. Lawmakers are expected to be in session for most of June, with the administration pushing for the bill’s passage by July 4.⁹