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Article | Insider

House approves bill to codify rules expanding HSA use for chronic conditions

By Ann Marie Breheny and Benjamin Lupin | March 13, 2025

The Chronic Disease Flexible Coverage Act codifies guidance that permits HSA-qualifying HDHPs to treat specified items and services used to manage chronic conditions as preventive.
Benefits Administration and Outsourcing Solutions|Health and Benefits
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The U.S. House of Representatives approved the bipartisan Chronic Disease Flexible Coverage Act on March 4 by voice vote. The act would codify IRS Notice 2019-45, which expands the list of preventive care benefits that can be provided by a high-deductible health plan (HDHP) with no (or low) cost sharing. Specifically, health savings account-qualifying HDHPs would be allowed to treat specified medical items and services that manage chronic conditions — such as coronary artery disease, diabetes, asthma, liver disease or bleeding disorders, heart disease or depression — as preventive care, allowing them to be covered before the individual’s minimum annual deductible is met.

The legislation is now cleared for Senate action, but the outlook for final enactment is unclear.

Notice 2019-45 remains in effect for plan sponsors that rely on — or wish to implement — the guidance.

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