New HSA Enhancements Just Became Law – Here’s What They Mean

The newly enacted "One Big Beautiful Bill" is ushering in positive changes for HSAs. 

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Health Savings Accounts (HSAs) have long been touted as one of the most powerful tools in a benefits and retirement planning toolkit. Now, under the One Big Beautiful Bill Act, HSAs will be getting even better.  Here’s a breakdown of what’s in the newly passed legislation and why benefits professionals should pay attention.
 
Removing the Flexible Spending Account (FSA) Prohibition
(effective plan years beginning on or after 1/1/2026)
Currently, an employee is typically not eligible to deposit into an HSA when their spouse is enrolled in an FSA (it would have to be a special type of FSA to allow the employee to then make HSA deposits). The new law removes this barrier, allowing individuals to contribute to an HSA even if their spouse is enrolled in any type of FSA. And even more advantageous, the spouse’s FSA could reimburse the employee's own medical expenses (for example, deductible and copays) and it will not disqualify him from contributing to his HSA.
 
Direct Primary Care and On-Site Clinics
(effective for months beginning after 12/31/2025)
Currently, use of on-site clinics or direct primary care (DPC) models can disqualify someone from contributing to an HSA unless the care is “preventive.” The new law expands HSA eligibility to access these services even if the services aren’t strictly preventive. This removes a key barrier for employers exploring value-based care models and for individuals who might want to sign up for direct care access with a provider. In addition, HSA-eligible individuals can use HSA funds to pay up to $150/month (individual) or $300/month (family) of the DPC membership fees.
 
Telehealth & Remote Care Safe Harbor
(effective plan years beginning on or after 1/1/2025)
During the pandemic, and through to 12/31/2024, high deductible health plans were allowed to provide pre-deductible telehealth care without a member losing the ability to deposit funds into their HSA bank account. This provision sunset as of 12/31/2024. But now under the BBB, this has now been reinstated and is retroactively effective for plan years beginning on or after 1/1/2025.
 
Individual Bronze & Catastrophic ACA Plans
(effective 1/1/2026)
One of the main, very stringent rules, of being able to deposit money into an HSA bank account is that the person must be enrolled for coverage on an HSA-qualified medical plan. These types of plans have high deductibles and do not allow any coverage prior to meeting that deductible other than preventive care. The BBB opens up HSA contributions to more individuals - to also include some individual medical plans. Anyone enrolling on an Affordable Care Act individual medical plan that is classified as either a Bronze level plan or as a Catastrophic plan will now be allowed to open an HSA bank account and make pre-tax contributions. ​

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The Bottom Line
 
Now that the bill has passed, HSAs are poised to become even more central to both health and retirement planning.  The changes open the door for more strategic use of HSAs. It also adds flexibility to emerging health delivery models like DPC and strengthens the link between HSAs and long-term financial wellness.
 
Benefits professionals need to understand the new HSA world, particularly as 2026 plan design conversations begin to take shape in the coming months. ​

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 A Final Note
 
While several impactful HSA reforms were passed, some proposed changes were not included in the final signed bill. These include:
 
Expanded Eligibility for Medicare Enrollees
Under current law, individuals enrolled in Medicare Part A (even if only involuntarily through Social Security’s automatic enrollment) are prohibited from contributing to an HSA. The proposed law would have allowed individuals enrolled in Medicare Part A to continue contributing to HSAs, but unfortunately was not included in the final signed version.
 
Fitness and Wellness Reimbursement
The proposed law would have allowed tax-free HSA reimbursements for gym memberships, fitness classes, and certain wellness programs, up to $500 per year.  

More Flexibility for Contributions and Catch-Up Rules
Currently anyone age 55+ who qualifies to contribute to an HSA can also deposit up to $1000 in catch-up contributions per calendar year. But while regular contributions can be deposited into either spouse's HSA bank account, the catch-up contribution is specifically limited to only being deposited into that over-age person's named HSA bank account. Original wording under the BBB would have allowed both spouses to deposit catch-up contributions into a single HSA, avoiding the need for separate accounts. 

On-site Employer Clinic Services Exempted from HSA
Some had hoped that employers who offer on-site clinic services to their employees would also be allowed without affecting HSA eligibility, like the OBBBA is going to now allow Direct Primary Care services to be exempted. However, being eligible for an on-site clinic's services, if they provide non-preventive care, will continue to disqualify a person from depositing funds into their HSA bank account.

Allowing HSA Funds to Reimburse Additional Premiums
Currently Medicare A, B, D and Medicare Advantage plan premiums are allowed to be reimbursed from HSA funds. It was originally proposed to expand this to include Medigap/Medicare Supplement plan premiums as well as individual premiums, but these were not added to the approved list of reimburseable premiums.
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