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HSA Improvements Could Cost $58 Billion: CBO

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Analysts at the Congressional Budget Office estimate that a health savings account improvement bill could increase the federal budget deficit by about $58 billion over 10 years.

Letting people who are signed up for Medicare contribute to HSAs would account for $8.5 billion of the increase.

Boosting the HSA contribution limit to $7,500, from $3,850, for self-only coverage and to $15,000, from $7,750, for family coverage would add $44 billion to the deficit.

The CBO analysts put those predictions in an assessment of H.R. 5687, the HSA Modernization Act of 2023 bill, which was approved by the House Ways and Means Committee in September.

What it means: The idea of expanding the HSA program is popular with Republicans and many Democrats, but the cost of the expansion makes getting the legislation through Congress a heavy lift.

The context: The Office of Management and Budget, an arm of the White House, provides benchmarking data for federal tax change proposals when it prepares the Analytical Perspectives report each year.

One section covers “tax expenditures,” or the revenue the federal government loses due to tax credits, tax exclusions and other tax law provisions.

The group health premium tax exclusion tops the list, with an estimated impact of $3.4 trillion from 2023 through 2032.

The full $58 billion predicted impact of H.R. 5687 is roughly comparable to the $61 billion 10-year budget impact of the tax break for students’ scholarship and fellowship income.

The $8.5 billion impact of letting Medicare enrollees contribute to HSAs is similar to the $9.2 billion impact of federal tax incentives for preservation of historic buildings.

Credit: Shutterstock


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