The One Big Beautiful Bill Act (OBBBA) was signed into law on July 4, 2025, introducing significant updates to Health Savings Accounts (HSAs). Following this, the IRS released Notice 2026-5 to provide specific guidance on how these changes expand HSA eligibility and usage.
The OBBBA broadens HSA availability through the following key provisions:
1. Permanent Telehealth Flexibility
The ability to receive telehealth and other remote care services before reaching the High Deductible Health Plan (HDHP) deductible has been made permanent. This ensures that individuals can access remote care without losing their HSA eligibility. This extension is effective for all plan years beginning after December 31, 2024.
2. Integration with Direct Primary Care (DPC)
The new law officially recognizes Direct Primary Care (DPC) arrangements as compatible with HSAs.
- Individuals in these arrangements can now contribute to an HSA.
- Periodic DPC fees are now classified as qualified medical expenses, meaning they can be paid for using tax-free HSA funds.
3. Expanded Plan Compatibility
Bronze and catastrophic plans offered through the ACA Exchange are now designated as HSA-compatible. This change applies regardless of whether these specific plans meet the traditional IRS requirements for an HDHP, significantly increasing the number of Americans eligible to open and fund an HSA.
Strategic Outlook for Employers
While some provisions are currently active, the majority of the OBBBA’s employee benefit changes will take full effect in 2026. Employers are encouraged to review these regulatory updates immediately to ensure benefit packages remain compliant and optimized for the coming year.