HSA changes that became law in the OBBBA – IRS Q/A explanation

Today, 12/09/2025, the IRS issued Notice 2026-5 titled “Expanded Availability of Health Savings Accounts under the One, Big, Beautiful)Bill Act (OBBBA)“. This notice should not be confused with the proposed bill that Bogdan wrote about in an earlier Humble Dollar article on 11/27/2025.

The 2026-5 notice provides guidance on changes relating to health savings accounts (HSAs) that were enacted and these changes generally expand the availability of HSAs .

Key points of the notice-

Made permanent a safe harbor for the absence of a deductible for telehealth and other remote care services in existing law.

Amended tax law for months beginning after December 31, 2025 to provide that the term “high deductible health plan” includes certain plans described as bronze  level plan or a catastrophic plan under  the Patient Protection and Affordable Care the Patient Protection and Affordable Care Act (ACA) available as individual coverage through an Exchange.

Certain Direct Primary Care Service Arrangements (DPCSA) fees are treated as amounts paid for qualified medical expenses under tax law that may be reimbursed by an HSA.

If you think may now fall under one of these new areas that OBBBA expanded HSA coverage to you may want to read the linked detailed notice and likely get specific authoritative confirmation regarding your ability to utilize a Health Savings Account before taking action.  The tax  goal is to make your expense pretax instead of a post tax expense.