The ACCESS Act allows individuals enrolled in high deductible health plans through the Affordable Care Act marketplace to choose receiving direct contributions to a health savings account instead of receiving subsidies that reduce their out-of-pocket costs. Under this option, insurance companies would deposit money into enrollees' health savings accounts each month equal to the value of the cost-sharing assistance they would have otherwise received, with the federal government reimbursing insurers for these payments. Money deposited this way could only be spent through a special medical debit card for qualified medical expenses, and the changes would take effect for months beginning January 1, 2025. The bill requires health insurance exchanges and insurers to educate consumers about this option starting in 2025 and mandates that insurers offering standard silver-level health plans also offer a high deductible health plan alternative. Congress would provide permanent funding to cover the cost of these health savings account contributions and existing cost-sharing reduction payments.
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