PlainBillCongress, translated.Legislation. Context. Public interest.Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Congressional Research Service
No official summary is available in the imported record yet.
People & committees
Rep. Steube, W. Gregory [R-FL-17] · R–FL
Legislative record
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Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Introduced in House
Introduced in House
Primary sources
Text links open the official source. We also preserved the text version used in the PlainBill explanation below.
No related bills are listed in this snapshot. This does not establish whether the proposal has appeared in earlier Congresses.
Source last updated: Feb 12, 2026. Consult Congress.gov for the current record.
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PlainBill explanation
Based on the full Introduced in House · 2025-02-10 text. This explanation has not received human editorial review. This overview describes the proposal’s major provisions; it does not establish what its real-world effects would be.
The proposal would let eligible people with high-deductible insurance bought through an Affordable Care Act marketplace choose insurer payments into a health savings account instead of reductions in what they pay when receiving care. Insurers would receive federal reimbursement for those deposits. Participating accounts would restrict withdrawals to medical debit-card payments during months receiving deposits. The bill would also require certain insurers to offer a high-deductible alternative and provide ongoing federal funding for both existing cost-sharing reduction payments and the new account payments.
section 1402 of the Patient Protection and Affordable Care Act shall not apply to such individual for such month
the health insurance issuer offering such plan shall make a payment to a health savings account of such individual for such month in an amount equal to 1/12 of the annual reduced cost-sharing actuarial equivalent amount
the Secretary shall make payments to such health insurance issuer in amounts which are equal to the payments made by such issuer under subparagraph (B).
during any month during which such a payment is received, no distribution may be made from such trust unless such distribution is made to satisfy a charge properly made to a qualified medical debit card.
unless the health insurance issuer offering such plan offers a high deductible health plan which is actuarially equivalent to such plan
(d) Permanent appropriation for cost-Sharing reduction payments and HSA contributions made in lieu of such payments Necessary amounts are appropriated to the Secretary of the Treasury for making payments described in section 1402(d)(3) of the Patient Protection and Affordable Care Act, and payments described in section 223(i)(1)(C) of the Internal Revenue Code of 1986 (as added by this section), for months beginning after December 31, 2025.
Section 1 names the proposal the Affordable Care and Comprehensive Economic Support through Savings Act, or ACCESS Act.
This Act may be cited as the Affordable Care and Comprehensive Economic Support through Savings Act or the ACCESS Act.
Eligible people enrolled in a marketplace high-deductible plan could elect the account-payment option for a month, using timing and procedures set by the Secretary. For that month, the existing Affordable Care Act cost-sharing reduction provision would not apply to them. The bill incorporates the existing statutory definition of an eligible insured person rather than listing eligibility requirements.
In the case of any eligible insured who is enrolled in an Exchange-provided high deductible health plan for any month and who elects (at such time and in such manner as the Secretary may provide) the application of this subsection— (A) section 1402 of the Patient Protection and Affordable Care Act shall not apply to such individual for such month
The term eligible insured has the meaning given such term in section 1402(b) of the Patient Protection and Affordable Care Act.
any high deductible health plan enrolled in by such eligible insured through an Exchange established under the Patient Protection and Affordable Care Act.
The insurer would deposit one-twelfth of an annual equivalent amount each month, and the federal government would reimburse the insurer for those deposits. The annual amount would match the calculated insurance value of the cost-sharing reduction otherwise available for that plan year, taking household income into account. This is a value calculation, not a promise to cover each person's actual medical bills.
(B) the health insurance issuer offering such plan shall make a payment to a health savings account of such individual for such month in an amount equal to 1/12 of the annual reduced cost-sharing actuarial equivalent amount, and (C) the Secretary shall make payments to such health insurance issuer in amounts which are equal to the payments made by such issuer under subparagraph (B).
an amount that would produce an actuarial value equal to the actuarial value of the reduction in cost-sharing (as determined under section 1402 of the Patient Protection and Affordable Care Act and without regard to any election under this subsection) for the plan year determined by taking into account the household income of the eligible insured.
An account receiving these deposits would have to prohibit all withdrawals except payments for properly charged medical debit-card expenses during any month a deposit is received. Without that restriction in its terms, the account would not qualify as a health savings account under this tax-code section.
Any trust which receives a payment described in paragraph (1)(B) shall not be treated as a health savings account for purposes of this section unless the terms of such trust require that, during any month during which such a payment is received, no distribution may be made from such trust unless such distribution is made to satisfy a charge properly made to a qualified medical debit card.
The required medical debit card would have to be issued by a bank, supplied to the account beneficiary by the account trustee, and encoded to allow only expenses meeting the tax code's definition of medical care.
the term qualified medical debit card means a debit card which— (i) is issued by a bank (as defined in section 408(n)), (ii) is provided by the trustee of the health savings account to the designated beneficiary, and (iii) is encoded in such a manner that the only expenses which may charged with such card are amounts paid for medical care (as defined in section 213(d)).
The proposal would use existing tax-credit rules for recovering excess payments. Account deposits would be treated as advance tax-credit payments, and the credit used in that calculation would be increased by the deposits that would have been due using the person's household income for the relevant tax year.
For purposes of applying the recapture rules of section 36B(f)(2)— (A) payments made to the health savings account of an individual under paragraph (1)(B) shall be treated as an advance payment of the credit allowed under section 36B, and (B) the credit allowed under section 36B shall be treated as having been increased by the payments which would have been made to the health savings account of such individual under paragraph (1)(B) if such payments had been determined using the household income of such individual for the taxable year referred to in such section.
The insurer's deposits would count as contributions under the health savings account rules. Deposits would not be required to the extent that the person has no health savings account or the account is prohibited from accepting the payment under the cited contribution-limit provision.
The payments described in paragraph (1)(B) shall not fail to be taken into account under this section as contributions to the health savings account to which paid and such payments shall not be required to be made to the extent that the eligible insured does not have a health savings account or such account is prohibited from accepting such payment by reason of subsection (d)(1)(A)(ii).
An insurer offering an individual-market silver-level plan that is not a high-deductible plan would have to offer a high-deductible alternative with equivalent calculated insurance value to people who would meet the referenced eligibility definition. Otherwise, the silver plan would lose its status as a qualified health plan under the Affordable Care Act.
A health plan in the silver level of coverage in the individual market which is not a high deductible health plan shall not be treated as a qualified health plan unless the health insurance issuer offering such plan offers a high deductible health plan which is actuarially equivalent to such plan to any individual who would be an eligible insured (as defined in section 1402(b)) if such individual were enrolled in such plan.
A high-deductible plan would qualify as a qualified health plan only if its insurer complied with the account-deposit requirement when an eligible person elected it. The proposal uses the tax code's existing definition of a high-deductible health plan.
A high deductible health plan shall not be treated as a qualified health plan unless the health insurance issuer offering such plan complies with the requirement of section 223(i)(1)(B) of such Code with respect to such plan.
For purposes of this paragraph, the term high deductible health plan has the meaning given such term by section 223 of the Internal Revenue Code of 1986.
When calculating a high-deductible plan's actuarial value—its calculated insurance value for purposes of the Affordable Care Act—the insurer's payments into an enrollee's health savings account would have to be included.
For purposes of this Act, the actuarial value of a high deductible health plan shall take into account payments made by the issuer to a health savings account of the enrollee pursuant to such plan.
Beginning January 1, 2026, the proposal would require every marketplace and every insurer offering marketplace coverage to inform all prospective enrollees about the account-payment option for silver-level high-deductible plans and how to establish and use a health savings account.
Beginning on January 1, 2026, each health insurance issuer offering coverage through an Exchange established under the Patient Protection and Affordable Care Act, and each such Exchange, shall provide all prospective enrollees— (1) information regarding the availability of insurer-provided health savings account contributions in lieu of reduced cost-sharing for silver level high deductible health plans selected in the Exchange, and (2) information regarding how to establish and use a health savings account.
The bill would directly appropriate the amounts needed for existing cost-sharing reduction payments and federal reimbursement of the new account deposits for months after December 31, 2025. This would provide funding, rather than merely authorize a future appropriation. The provision is labeled permanent and specifies neither a fixed dollar amount nor an end date.
(d) Permanent appropriation for cost-Sharing reduction payments and HSA contributions made in lieu of such payments Necessary amounts are appropriated to the Secretary of the Treasury for making payments described in section 1402(d)(3) of the Patient Protection and Affordable Care Act, and payments described in section 223(i)(1)(C) of the Internal Revenue Code of 1986 (as added by this section), for months beginning after December 31, 2025.
The proposed statutory amendments would apply to months beginning after December 31, 2025. This is the introduced bill's proposed effective date, not evidence that the changes took effect.
The amendments made by this section shall apply to months beginning after December 31, 2025.
The supplied official-actions snapshot, updated February 12, 2026, records introduction in the House on February 10, 2025, and referral that day to the Ways and Means and Energy and Commerce committees for provisions within their respective jurisdictions.
Source snapshot updated 2026-02-12T09:06:30Z.
2025-02-10: Introduced in House
2025-02-10: Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
A closer look
Reviewed version: Introduced in House · 2025-02-10. These findings describe provisions and who may benefit; they are not judgments of waste, corruption, or motive.
This review covers the supplied bill text. “None identified” does not rule out provisions in later versions or accompanying reports and disclosures.
Provisions outside the bill’s main subject, or policy changes attached to appropriations.
None identified in the reviewed text
No unrelated provision or policy rider attached to appropriations was identified in the complete supplied introduced text. Its provisions form a connected health-coverage and account-funding proposal. This conclusion is limited to that version and does not establish attachment history or the contents of other versions or accompanying materials.
Spending directed to particular recipients or places outside ordinary competitive or formula-based allocation.
None identified in the reviewed text
No congressionally directed spending for particular recipients or places outside general program rules was identified in the complete supplied introduced text. This conclusion is limited to that version; the absent disclosure and committee materials prevent a broader formal earmark determination.
Narrow exceptions, exemptions, or preferential treatment that warrant a closer look.
None identified in the reviewed text
No materially narrow carve-out, special exemption, or preferential treatment warranting a finding was identified in the complete supplied introduced text. Coverage of the program's intended beneficiaries does not alone constitute a targeted benefit. This conclusion is limited to that version and does not cover other versions or accompanying materials.
Full text preserved for this analysis. Legislative record snapshot: Feb 12, 2026. How PlainBill uses AI