Kentucky's U.S. Sen. Rand Paul files bill to make all Americans eligible for Health Savings Accounts

Kentucky's junior U.S. Senator Rand Paul, R-Bowling Green, has introduced the Health Marketplace and Savings Accounts for All Act, to make all Americans eligible for Health Savings Accounts (HSAs).

It would also expand Association Health Plans to provide maximum leverage to negotiate lower premiums with health insurance companies.

"Two of the most daunting problems facing Americans are the lack of affordable healthcare options and the fear of exorbitant medical bills," said Paul. "With my plan, to provide the leverage needed to reduce the cost of premiums, nearly any conceivable membership entity, such as Costco or Amazon, would be empowered to collectively bargain on behalf of their members with health insurers to lower rates.

"Additionally, this legislation improves the treatment of health savings accounts so all Americans can obtain them, increases the tax-free maximum contribution by thousands of dollars, and expands what HSAs can be used to pay for, such as health insurance premiums and gym memberships. If we want lower premiums and better care, we need more choice and competition."

Employer-sponsored insurance can offer strong coverage for those who have it, but many Americans do not work for large corporations and cannot access the same bargaining power and economies of scale. At the same time, Americans collectively owe over $200 billion in medical debt, and families often struggle to pay for expenses that fall outside their insurance plans.

HSAs already give millions of Americans the freedom and flexibility to save and pay for medical costs insurance does not cover. Contributions are tax-free, balances can grow tax-free, and withdrawals remain tax-free when used for qualified medical expenses. HSAs also stay with an individual for life, regardless of employment status.

The bill would open HSAs to all Americans, regardless of income level or current insurance coverage, to take advantage of a tax-free HSA. It would raise the maximum annual HSA contribution to $24,500 for 2026. By contrast, for 2026, the current HSA contribution limit is only $4,400 for an individual and $8,750 for a family.

It additionally expands what HSAs can cover to include health insurance premiums, vitamins and dietary supplements, gym memberships and wearable fitness trackers, so Americans can use their own money to invest in prevention, wellness and coverage that works for them.

No word on when the measure might be taken up in committee.

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