New HSA rules from the One Big Beautiful Bill Act (effective 2026)

The One Big Beautiful Bill Act  (H.R.1) was signed into law on July 4, 2025, and implements several important updates to Health Savings Account rules that will open the door for more clients.

Big news for HSA fans: Starting Jan. 1, 2026, all Marketplace Bronze and Catastrophic plans will be considered HSA-compatible. This is a significant change because in the past only select Bronze plans were eligible and limited who could open or contribute to an HSA. Now, Marketplace enrollees will have broader access to tax-advantaged savings for health care expenses. (Sec. 71307).

But that’s not all: Direct Primary Care (DPC) arrangements are now HSA-friendly. Individuals can pay a fixed periodic fee of up to $150 per month, or $300 for families, for enrollment in a primary care arrangement without losing their eligibility to contribute to an HSA. The fees paid for a DPC arrangement are treated as medical expenses. Note: This change impacts HSA rules only. Access to and enrollment in a DPC arrangement is not a covered benefit. (Sec. 71308).

A Win for telehealth: The “Safe Harbor” rule for telehealth is now permanent. This means High Deductible Health Plans can provide benefits for telehealth visits before your deductible is met, and you’ll still qualify for an HSA. This now applies retroactively to plan years beginning after Dec. 31, 2024. (Sec. 71306).

What’s not changing: It’s important to know that these changes only apply to Marketplace coverage. Off-exchange Bronze plans and group Bronze plans must still meet standard HDHP criteria to remain HSA-compatible.