Updates to health savings accounts (HSAs) were some of the key benefit provisions that speakers Brigen Winters, Kathryn Bjornstad Amin and Michael Kreps, principals at Groom Law Group, Chartered, reviewed in a recent International Foundation webcast on the One Big Beautiful Bill Act (OBBBA)(HR 1). These provisions are intended to allow more people to save for future health care expenses (potentially large, unexpected medical bills) while using primary care for routine health care services. The speakers also shared their thoughts on possible future tax legislation impacting employee benefit plans.

Direct Primary Care Arrangements, Bronze and Catastrophic Plans

In addition to being compatible with high-deductible health plans (HDHPs) as defined by the Internal Revenue Service (IRS) and indexed for inflation, starting January 1, 2026, HSAs will be compatible with direct primary care (DPC) service arrangements, bronze and catastrophic plans.

Under current law, HDHPs are defined with a minimum deductible and maximum out-of-pocket limit. According to IRS Revenue Procedure 2025-19, for calendar year 2026, HDHPs will have a deductible set at a minimum of $1,700 for self-only coverage and $3,400 for family coverage as well as an out-of-pocket limit of $8,500 for self-only and $17,000 for family coverage. The annual HSA contribution limit is indexed for inflation. In 2026, the limit is $4,400 for self-only coverage and $8,750 for family coverage.

Under OBBBA, a direct primary care service arrangement means an arrangement under which an individual (or family) receives primary care services provided by primary care practitioners, and the sole compensation for care is a fixed periodic fee. The law sets limits on fees at $150 per month for individual care and $300 per month for family care. If the criteria are met, an individual will be eligible to contribute to an HSA while paying for this DPC service arrangement and can use HSA distributions to pay the monthly fees.

Currently, bronze and catastrophic plans haven’t met criteria for HDHPs either because the deductible was too low or the out-of-pocket max was too high, Bjornstad Amin explained. New starting January 1, 2026, bronze and catastrophic plans will be automatically HSA-compatible, so enrollees will be eligible to contribute to HSAs.

What could individual coverage look like?  

On September 26, 2025, the White House Council of Economic Advisors published “Expansion of HSA Eligibility Under OBBB Act to Improve Marketplace Coverage, Affordability, and Access,” suggesting how these expansions could work in combination.

“Taken together, an individual could find it attractive to use their HSA to pair a DPC membership with a catastrophic health plan to provide access to primary care at an affordable price with financial protection in case of a serious and unforeseen medical event,” the Council of Economic Advisors report said.

What’s the impact on employers?

Employers aren’t offering bronze or catastrophic plans, but an employer could allow employees who are enrolled in those plans to contribute to the HSA pre-tax, or the employer could contribute pre-tax to the employee’s HSA, Bjornstad Amin told the webcast audience.

During the webcast Q&A, an audience member stated that there are some bronze plans covering traditional office visits and wondered if those plan designs would have to change. Unless future IRS guidance says otherwise, the law says the plans are automatically compatible. So, yes, it seems that a bronze plan could cover office visits services pre-deductible, Bjornstad Amin said.

As far as employers’ connection to direct primary care arrangements, HUB’s EB Compliance Team addresses the scenario where an employer provides access to the DPC as part of its medical benefits program. HUB’s compliance bulletin states, “For purposes of HSA eligibility, employers are only responsible for the plans they sponsor. Thus, if an employer offers a DPC to participants in their HDHP, the employer is responsible for ensuring that the DPC is HSA compatible. On the other hand, employers are not responsible for determining whether a DPC engaged at the individual level is HSA compatible.”

Future Tax Legislation

Plan sponsors should be aware that just because taxation of defined contribution plans, defined benefit plans or health plans weren’t impacted by the OBBBA, that could change in future lawmaking. There’s an intensity for federal government revenue going forward, Kreps said, and we could therefore expect more employee benefits–related laws in the next two years.

Winters added that, as some of the largest tax expenditures, the tax deferral for retirement plans and the tax exclusion for employer-sponsored health insurance could be revenue raisers in future tax proposals.

Learn More

Members can view the webcast recording to learn how OBBBA makes 529 plans more flexible; allows HSAs to pay monthly fees for direct primary care arrangements; and changes the paid family and medical leave tax credit, dependent care assistance programs, executive compensation and more.

Developed by International Foundation Information Center staff. This does not constitute legal advice. Please consult your plan professionals for legal advice.