On December 9, the IRS issued guidance on new tax benefits for health savings accounts (HSAs) made under Public Law 119-21, known as the One Big Beautiful Bill Act (OBBBA) [Notice 2026-5, 12-9-25]. The OBBBA amended IRC §223, which permits eligible individuals to establish an HSA.
Changes Under the OBBBA
Here are two changes the OBBBA makes to HSAs and high-deductible health plans (HDHPs).
- Telehealth and remote care. OBBBA §71306 amends IRC §223(c)(2)(E) to clarify that a health plan can still be considered an HDHP even if it offers telehealth and other remote care services without requiring a deductible. This allows employers to provide telehealth and other remote care services to HDHP participants on a pre-deductible basis without causing employees to become ineligible to contribute to HSAs. This amendment applies to plan years beginning after December 31, 2024, and retroactively makes permanent the same provision from the Coronavirus Aid, Relief, and Economic Security (CARES) Act.
- Direct primary care service arrangements. OBBBA §71308 amends IRC §223(c)(1) by adding paragraph (E), which allows direct primary care service arrangements to be compatible with HSAs. Effective after December 31, 2025, direct primary care arrangements are eligible for HSA coverage, as long as the membership fee does not exceed $150 per month for an individual ($300 per month if the arrangement covers more than one person).
More Information
PayrollOrg will provide information to members as soon as the guidance is available. Check the OBBBA Payroll Hot Topics page for the latest updates.
To learn more about federal and state laws, regulations, and information to keep your company's payroll operations in compliance, check out Payroll Source Plus!
Jyme Mariani, Esq., is Director of Payroll Information Resources for PayrollOrg.
