H.R. 6309 would amend the Internal Revenue Code to allow an individual who is eligible for benefits under Medicare Part A because they are over age 65 to make deductible contributions to a Health Savings Account (HSA).
Subject to certain limits, contributions made by an individual to an HSA are deductible for income tax purposes, and contributions made through a cafeteria plan are excludible from income for both income and payroll tax purposes. Individuals are generally eligible to participate in an HSA if they are covered by a high deductible health plan and no other health care plan, except for certain types of coverage specifically disregarded by law. Under current law, when an individual is automatically enrolled in Medicare they are no longer eligible to contribute to an HSA.
The staff of the Joint Committee on Taxation (JCT) estimates that enacting H.R. 6309 would reduce revenues by $5.5 billion over the 2019-2028 period. The change in revenues includes a reduction of about $1.7 billion over the 2019-2028 period that would result from changes in off-budget revenues (from Social Security payroll taxes). CBO estimates that enacting H.R. 6309 would not affect direct spending.
The Statutory Pay-As-You-Go Act of 2010 establishes budget-reporting and enforcement
procedures for legislation affecting revenues or direct spending. The net changes in
revenues and direct spending that are subject to those pay-as-you-go procedures are shown in the following table. Only on-budget changes to revenues and direct spending are subject to pay-as-you-go procedures.
CBO and JCT estimate that enacting H.R. 6309 would increase on-budget deficits by more than $5 billion in at least one of the four 10-year periods beginning in 2029. CBO estimates that enacting the bill would not increase net direct spending in any of the four consecutive 10-year periods beginning in 2029.
JCT has determined that the bill contains no intergovernmental or private-sector mandates as defined in the Unfunded Mandates Reform Act.